Comparison of Xylocaine with Adrenaline and Cocaine in the Nasal Endoscopy: a Randomized Double Blind Controlled Trial

Abstract

Comparison of Xylocaine with Adrenaline and Cocaine in the Nasal Endoscopy: a Randomized Double Blind Controlled Trial

Pichai Puapermpoonsiri MD

Department of Otolaryngology, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis

Objectives: To compare pain, thoroughness, and complications of the nasal endoscopic examination between the patients who received xylocaine with adrenaline and cocaine.

Methods: This double blind randomized controlled trial was carried out in 64 patients undergoing nasal endoscopy at the out patient unit of the Department of Otolaryngology, Faculty of Medicine Vajira Hospital. The patients were randomized to receive local anesthetic agents via applicator soaked with either 2% xylocaine with adrenaline diluted 1:80,000 or 5% cocaine at posterior part of middle and inferior turbinates 10 minutes prior to nasal endoscopy. Visual analogue pain score and pain level, thoroughness of the examination, and complications from the procedures between the two groups were compared.

Results: Thirty-two patients received local anesthetic agent as 2% xylocaine with adrenaline 1:80,000 while the other 32 received 5% cocaine. Pain score was 2.50 ฑ 1.16 (95% confidence interval [CI], 2.10 - 2.90) and 2.47 ฑ 1.27 (95% CI, 2.03 - 2.90), respectively. The corresponding pain levels were: mild in 78.1% and 87.5%, moderate in 21.9% and 12.5%. The differences of pain score and pain level were not statistical significantly different. The thoroughness of the examination to the nasopharynx level between both groups was not significantly different, 75.0% in the xylocaine group compared to 84.3% in the cocaine group. Complications were not encountered in both groups.

Conclusion: The pain, thoroughness and complications during nasal endoscopy between the patients having local 2% xylocaine with adrenaline 1:80,000 and 5% cocaine were not significantly different.

Keywords: xylocaine with adrenaline, cocaine, nasal endoscopy, pain score