Is topical local anaesthesia necessary when performing paediatric flexible nasendoscopy? A double-blind randomized controlled trial

Jonas, Nico; Visser, Mariet; Oomen, A.P.A.; Albertyn, René; Dijk, Monique van; Prescott, C.A.J.

doi:10.1016/j.ijporl.2007.07.001

Cited by 17 publications

(12 citation statements)

References 13 publications

(17 reference statements)

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“…Although the probe shaft is 3 mm, its tip is 6 mm, a little larger than an ultra-slim endoscope, and we believe that the routine use of oxymetazoline hydrochloride, a selective alpha-1 agonist and partial alpha-2 agonist topical, influences such a high success rate for nasal intubation. Previous studies have shown that the use of oxymetazoline for pediatric nasendoscopy is effective, safe and allows an ease of performance and cooperation of the patients [24] . Although we prepared the patient with an assurance of a successful nasal intubation, we did not use simethicone routinely, a compound that has been used in several studies to improve visibility [25] .…”

Section: Discussionmentioning

confidence: 99%

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Aedo

Zavala-González

Meixueiro-Daza

et al. 2014

WJGE

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AIM:To assess feasibility of unsedated esophagoscopy using a small-caliber disposable transnasal esophagoscopy and to compare its accuracy with standard endoscopy. METHODS:We prospectively included subjects who were referred for upper endoscopy. All subjects underwent transnasal endoscopy with E.G. Scan™. The disposable probe has a 3.6 mm gauge and at its distal end there is a 6 mm optical capsule, with a viewing angle of 125°. Patients underwent conventional endoscopy after the completion of E.G. Scan™. We describe the findings detected by the E.G. Scan™ and calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa index for esophageal diagnosis. RESULTS:A total of 96 patients (54 women), mean age of 50.12 years (14 to 79), were evaluated. In all cases we were able to perform esophagoscopy with E.G.Scan™. The average realization time was 5 min. A total of 58 alterations were detected in the esophagus, 49 gastric abnormalities and 13 duodenal abnormalities. We found that for esophageal varices, E.G. Scan™ has sensitivity, specificity and diagnostic accuracy of 95%, 97% and 97%, respectively. Kappa coefficients were 0.32 for hiatal hernia, 0.409 for erosive gastroesophageal reflux disease, 0.617 for Barrett's esophagus, and 0.909 for esophageal varices. CONCLUSION:Esophagoscopy with E.G. Scan™ is a well-tolerated, fast and safe procedure. It has an appropriate diagnostic accuracy for esophageal varices when compared with conventional endoscopy.

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Section: Discussionmentioning

confidence: 99%

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Aedo

Zavala-González

Meixueiro-Daza

et al. 2014

WJGE

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“…Interestingly, even though lidocaine is an anesthetic, it does not reduce pain during endoscopy [5,11,19,20]. In this study, we showed that pain scores were similar between lidocaine and placebo.…”

Section: Discussionmentioning

confidence: 48%

Premedication Methods in Nasal Endoscopy: A Prospective, Randomized, Double-Blind Study

Şahin¹,

Kökoğlu²,

Güleç³

et al. 2017

Clin Exp Otorhinolaryngol

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ObjectivesTo identify the optimal pharmacological method of preparing patients for nasal endoscopy.Methods Twenty healthy volunteers were enrolled in this prospective, randomized, double-blind study. Four types of medications were applied in their nostrils with binary combinations of spray bottles on four different days in a random order: placebo (normal saline [NS]+NS), decongestant (NS+oxymetazoline), anesthetic (NS+lidocaine), and decongestant plus anesthetic (oxymetazoline+lidocaine). Rigid nasal endoscopy was performed 10 minutes after spray application. The volunteers evaluated the discomfort caused by each spray application, and nasal pain scores due to the passage of the endoscope. The physicians quantified nasal decongestion using a visual analogue scale. Endoscopy duration as well as pulse and mean blood pressure (MBP) before spray application, 10 minutes after the application, and immediately after endoscopic examination were also recorded.Results The discomfort caused by lidocaine was significantly higher than that caused by the other sprays (P<0.001). The lowest pain score related to endoscopy was obtained for oxymetazoline+lidocaine (P<0.001). Nasal decongestion was best achieved with NS+oxymetazoline (P<0.001). Endoscopy duration was the shortest for oxymetazoline+ lidocaine (P<0.05). Statistically significant MBP changes were only seen with the application of NS+oxymetazoline (P<0.05). However, neither MBP nor pulse rate change was significant clinically.Conclusion Application of decongestant and anesthetic sprays together seems to be the best method of pharmacological preparation of patients for nasal endoscopy.

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“…Participants were randomized in blocks of 3 to one of the 3 intranasal spray solutions using a pregenerated random number table. The 3 preparations were: (1) sodium chloride, 0.9% (normal saline), solution (placebo, group A); (2) xylometazoline hydrochloride, 0.05% (equal volumes of xylometazoline hydrochloride, 0.1%, and normal saline solution) (decongestant, group B); and (3) xylometazoline hydrochloride, 0.05%, with lidocaine hydrochloride, 1% (equal volumes of xylometazoline hydrochloride, 0.1%, and lidocaine hydrochloride, 2%, solution) (decongestant with TLA, group C). Administration of the test solution was performed by a nurse practitioner behind closed doors using a pharmacy-coded labeled bottle.…”

Section: Methodsmentioning

confidence: 99%

“…6 The secondary outcome measures were the caregiver-proxy WBFP scale; the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, 7 and the Difficulty of Procedure Visual Analog Scale (DPVAS). 3 The FLACC scale requires an observer to assign a rating from 0 to 2, based on predetermined descriptors of behavior, for each of 5 domains (face, legs, activity, cry, and consolability) to determine a total pain score from 0 to 10. 7 The DPVAS consisted of a visual analog scale based on a 100-mm line ranging from easiest to most difficult.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…In an uncontrolled study 2 of pain perception after decongestant and TLA, children reported moderate pain during the nasendoscopy. The only randomized clinical study 3 to compare nasal sprays before nasendoscopy in children determined no significant difference in discomfort between children who received decongestant and those who received decongestant combined with TLA. However, a placebo group was not included, and only proxy measures of discomfort were used.…”

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confidence: 99%

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Intranasal Topical Local Anesthetic and Decongestant for Flexible Nasendoscopy in Children

Chadha

Lam

Ludemann

et al. 2013

JAMA Otolaryngol Head Neck Surg

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This study revealed no statistically significant difference in the discomfort experienced by children undergoing flexible nasendoscopy after placebo, decongestant, or TLA with decongestant. Decongestant was associated with the least discomfort (on child, caregiver, and observer-rated pain scale scores) and the lowest rating for difficulty of procedure. With these findings, the study suggests that there is no significant benefit of topical decongestant with or without TLA compared with placebo in reducing pain associated with pediatric flexible nasendoscopy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01351298.

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Is topical local anaesthesia necessary when performing paediatric flexible nasendoscopy? A double-blind randomized controlled trial

Cited by 17 publications

References 13 publications

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Premedication Methods in Nasal Endoscopy: A Prospective, Randomized, Double-Blind Study

Intranasal Topical Local Anesthetic and Decongestant for Flexible Nasendoscopy in Children

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