The Anaesthetic Efficacy of Tetracaine and Oxymetazoline Compared With Co-Phenylcaine in Healthy Individuals

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-09-17 DOI:10.1111/coa.14223

Samuel J. M. Hale, Olivia Lengyel, Deanna Louis, Raymond Kim, Richard G. Douglas

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引用次数: 0

Abstract

Objectives

Nasal anaesthetic-decongestant sprays are commonly used prior to nasal instrumentation, such as flexible and rigid nasal endoscopy. Co-phenylcaine (lignocaine 5%, phenylephrine 0.5%, ENT Technologies Pty Ltd., Melbourne, VIC, Australia) is a combination spray commonly used for this purpose. However, lignocaine is less potent than other local anaesthetics, and both active constituents of Co-phenylcaine have a bitter taste. It was hypothesised that a combination spray containing tetracaine and oxymetazoline would both offer more potent topical anaesthesia and have a better taste.

Methods

Four anaesthetic-decongestant nasal sprays were tested in 10 healthy participants (Co-phenylcaine, and tetracaine 0.5%, 1% and 2% with oxymetazoline 0.05%). Sensory thresholds were sequentially measured at the head of the inferior turbinate using Semmes-Weinstein monofilaments over the following hour. Participants also rated taste on a Likert-style scale, and reported whether they experienced subjective numbness of the maxillary teeth.

Results

A median peak sensory threshold of 60 g (the maximum tested) was observed with Co-phenylcaine, but this threshold was exceeded by all the tetracaine-based sprays. Tetracaine 2% with oxymetazoline 0.05% had a significantly more rapid onset than Co-phenylcaine (4 min vs. 6 min, p < 0.05) and a longer duration of action. Eight participants reported dental numbness after administration of tetracaine 2% with oxymetazoline 0.05%, but only one participant after Co-phenylcaine. Tetracaine-based sprays were generally perceived to taste less unpleasant than Co-phenylcaine.

Conclusion

Tetracaine 2% with oxymetazoline 0.05% is a more potent and rapidly acting anaesthetic-decongestant spray than Co-phenylcaine, with a longer duration of action.

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四卡因和羟甲唑啉与共苯卡因在健康人中的麻醉效果比较

目的在进行鼻腔器械检查（如柔性和刚性鼻内窥镜检查）之前，通常会使用鼻腔麻醉剂-减充血剂喷雾剂。联苯卡因（5% 木酚卡因，0.5% 苯肾上腺素，ENT Technologies Pty Ltd., Melbourne, VIC, Australia）是一种常用的复合喷雾剂。然而，木质素卡因的药效不如其他局麻药，而且 Co-phenylcaine 的两种活性成分都有苦味。我们假设，含有四卡因和羟甲唑啉的复合喷雾剂既能提供更有效的局部麻醉，味道也会更好。方法在 10 名健康参与者中测试了四种麻醉剂-减充血剂鼻腔喷雾剂（氯苯卡因、四卡因 0.5%、1% 和 2%，羟甲唑啉 0.05%）。在随后的一小时内，使用塞姆斯-韦恩斯坦单丝在下鼻甲头部依次测量了感觉阈值。受试者还用李克特量表对味道进行评分，并报告他们是否有上颌牙齿麻木的主观感觉。结果观察到氯苯卡因的中位感觉阈值峰值为 60 克（测试的最大值），但所有基于四卡因的喷雾剂都超过了这一阈值。含 0.05% 奥美拉唑啉的 2% 四卡因的起效速度明显比联苯卡因快（4 分钟对 6 分钟，p < 0.05），作用时间也更长。有 8 名参与者在使用 2% 含氧甲唑啉 0.05% 的四卡因后出现牙齿麻木，但只有 1 名参与者在使用辅苯卡因后出现牙齿麻木。结论2% 含羟甲唑啉 0.05% 的四卡因是一种比联苯卡因药效更强、起效更快、作用时间更长的麻醉减充血喷雾剂。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.