Anesthesia, Local Clinical Trial
Official title:
Buffered vs Plain Lidocaine for Local Nasal Anesthesia
Transnasal Fiberoptic Laryngoscopy (TFL) is a common procedure in the otolaryngology clinic
for the examination of vocal cord appearance and function, inspection and follow up of benign
and malignant lesions, and investigating foreign body ingestion.
There are many forms for applying preprocedural local nasal anesthesia such as atomizers,
nebulizers, spray, soaked pads, or local anesthetic gel application.
This study compares the effect of buffered versus plain lidocaine for local nasal anesthesia.
Transnasal Fiberoptic Laryngoscopy (TFL) is a common procedure in the otolaryngology clinic
for the examination of vocal cord appearance and function, inspection and follow up of benign
and malignant lesions, and investigating foreign body ingestion.
There are many forms for applying preprocedural local nasal anesthesia such as atomizers,
nebulizers, spray, soaked pads, or local anesthetic gel application.
Products containing lidocaine are used in everyday practice, sometimes combined with
vasoconstrictors such as oxymetazoline or phenylephrine. Lidocaine does not require special
storage conditions and is a relatively inexpensive product.
Besides its use for local nasal anesthesia, lidocaine is also widely used for local and
regional anesthesia in dentistry, emergency medicine, and surgical or invasive procedures.
The addition of bicarbonate for lowering the acidity level of the solution has been studied
before in these applications. The buffered solution demonstrated decreased patients pain and
increased patient preference[1,2].
Solutions containing lidocaine with a vasoconstrictor such as epinephrine are widely used for
soft tissue injection. This combination allows the benefits of prolonged anesthetic and
decreased bleeding of the surgical site. However, this combination disadvantage includes
increased acidity of the solutions, which may cause increased pain or burning sensation
during drug administration. Alkalinization of combined lidocaine and epinephrine solutions
has shown decreased local site pain, shorter onset time, and longer duration of
anesthesia[3]. The addition of bicarbonate may be done by mixing into a syringe or other
suitable container in a relatively easy and fast application for clinical use. Alternatively,
a designated device may be used, such as the Onpharma mixing system (Onpharma), commonly used
in dentistry[4].
While the alkalinization of lidocaine had shown advantages in local injection into soft
tissues, its efficacy for local nasal anesthesia was not previously examined.
This study compares the effect of buffered versus plain lidocaine for local nasal anesthesia.
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