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A Comparison of xylometazoline (Otrivine) and phenylephrine/lignocaine mixture (Cophenylcaine) for the purposes of rigid nasendoscopy: a prospective, double-blind, randomised trial

  • N A McCluney (a1), C Y Eng (a1), M S W Lee (a1) and L G McClymont (a1)

Abstract

Objective:

To evaluate if phenylephrine–lignocaine mixture (Cophenylcaine) nasal spray performs better than xylometazoline (Otrivine) spray for the purposes of out-patient rigid nasendoscopy preparation.

Design:

Prospective, double-blind, randomised trial comparing visual analogue scores for out-patients receiving either phenylephrine–lignocaine mixture or xylometazoline, prior to undergoing rigid nasendoscopy as part of their assessment.

Subjects:

Seventy-three patients requiring rigid nasendoscopy as part of their assessment were recruited to the study from Raigmore Hospital's out-patient clinic. These patients were randomised to receive a nasal spray comprising either phenylephrine–lignocaine mixture or xylometazoline, 10 minutes prior to rigid nasendoscopy. Double-blinding was adopted. After the procedure, the patient and the doctor independently completed separate visual analogue score-based questionnaires regarding the pain of the procedure and the ease of the examination, respectively.

Results:

Analysis of the data using standardised statistical methods demonstrated that the phenylephrine–lignocaine mixture did not perform better than xylometazoline, to any statistically significant extent.

Conclusion:

Phenylephrine–lignocaine mixture is considerably more expensive and has potentially more side effects than xylometazoline. These study findings suggest that it is difficult to justify the use of phenylephrine–lignocaine mixture over xylometazoline, for nasal preparation prior to rigid nasendoscopy.

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Copyright

Corresponding author

Address for correspondence: Mr N A McCluney, 54 Charles Street, Aberdeen AB25 3TU, Scotland, UK. Fax: 01224 554569 E-mail: neilmccluney@doctors.org.uk

Footnotes

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Presented to the New Zealand Society of Otolaryngology, Head and Neck Surgery, 31st October to 3rd November 2006, Timaru, New Zealand.

Footnotes

References

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1 Douglas, R, Hawke, L, Wormald, PJ. Topical anaesthesia before nasendoscopy: a randomised controlled trial of co-phenylcaine compared with lignocaine. Clin Otolaryngol 2006;31:33–5
2 Pothier, DD, Hall, CEJ, Gillett, S. Timing of co-phenylcaine administration before rigid nasendoscopy: a randomised, controlled trial. J Laryngol Otol 2006;15:13
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5 Sadek, SAA, De, R, Scott, A. The efficacy of topical anaesthesia in flexible nasendoscopy: a double-blind randomised controlled trial. Clin Otolaryngol 2001;26:25–8
6 Walshe, P, Rowley, H, Hone, S. Co-phenylcaine as an alternative to Brompton's solution in rigid nasendoscopy: a pilot study. J Clin Pharm Therap 2002;27:185–7
7 Latorre, F, Otter, W, Kleeman, PP. Cocaine or phenylephrine/lignocaine for nasal fibre-optic intubation? Eur J Anaes 1996;13:577–81
8 Lennox, P, Hern, J, Birchall, M. Local anaesthesia in flexible nasendoscopy. A comparison between cocaine and cophenylcaine. J Laryngol Otol 1996;110:540–2
9 Cain, AJ, Murray, DP, McClymont, LG. The use of topical nasal anaesthesia before flexible nasendoscopy: a double-blind, randomised controlled trial comparing cophenylcaine with placebo. Clin Otolaryngol 2002;27:485–8

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