EMLA® cream as local anesthetic for radiofrequency turbinate tissue reduction

Abstract

Radiofrequency volumetric tissue reduction is a minimally invasive technique in the treatment of turbinate hypertrophy and is generally performed under local anesthesia. However, perioperative discomfort and pain are common side effects and studies concerning the technique of choice to anesthetize the nasal mucosa in this procedure are lacking. The aim of this prospective controlled trial is to assess the effectiveness of EMLA(®) cream as a topical anesthetic for radiofrequency volumetric tissue reduction of inferior turbinates comparing its effect with that obtained using a traditional anesthetic technique. 200 consecutive patients undergoing volumetric tissue reduction with topical anesthesia were enrolled. Patients were divided into two groups: Group A included 100 patients treated by placing cotton pledgets soaked with lidocaine 10% in the inferior meatus followed by the injection of 2% lidocaine into the head of the inferior turbinate; Group B included 100 patients treated with EMLA(®) cream. Patients were evaluated before and after surgery using rhinomanometry for obstructive symptoms. Four VAS about pain, troublesome swallowing, choking sensation and intraoperative anxiety were submitted to each patient immediately after surgery and after 2 months to assess various aspects of perioperative discomfort. A significant increase of nasal airflow was observed without differences between the two groups. Subjective evaluation regarding perioperative discomfort showed significant differences between Groups A and B immediately after surgery although it was less pronounced 2 months later. The results of this study suggest that EMLA(®) cream is an efficient tool in obtaining an adequate anesthetic effect in this procedure.

Effects of two different local anaesthetic methods vs no anaesthesia on pain scores for intratympanic injections

“…Administering anaesthetic agents by local injection has been shown to cause pain as well as needle anxiety, which increases the pain sensation 23 . Furthermore, haemorrhage, oedema and haematoma are possible side effects of local anaesthesia premedication administered via injection 24 25 …”

Effect of Radiofrequency Thermal Ablation Treatment on Nasal Ciliary Motility

“…Before treatment, a cotton pledget soaked with anesthetic emulsion was introduced into each inferior meatus. 8 After 5 minutes, the radiofrequency electrode was inserted submucosally under endoscopic guidance, and the energy was delivered at power adjustment 2 (6 W, total energy ≤54 J) during 2 consecutive applications with a 4-second duration and a 2-second interval at 3 sites of the turbinate (anterior, middle, and posterior portions). Continuous blood pressure, heart rate, and oxygen saturation measurements were taken during treatment.…”

“…The radiofrequency energy was delivered by a BM 780 II Sutter RF Generator with a bipolar RaVoR needle electrode (Binner; Select Sutter, Freiburg, Germany). Before treatment, a cotton pledget soaked with anesthetic emulsion was introduced into each inferior meatus 8 . After 5 minutes, the radiofrequency electrode was inserted submucosally under endoscopic guidance, and the energy was delivered at power adjustment 2 (6 W, total energy ≤54 J) during 2 consecutive applications with a 4‐second duration and a 2‐second interval at 3 sites of the turbinate (anterior, middle, and posterior portions).…”