Sarah Sussman, Kurren Gill, Sarah Wagoner, Joel Stanek, Ryan Heffelfinger, Howard Krein
{"title":"A randomized control trial employing infraorbital nerve stimulation as a neural distractor during nasopharyngeal swab.","authors":"Sarah Sussman, Kurren Gill, Sarah Wagoner, Joel Stanek, Ryan Heffelfinger, Howard Krein","doi":"10.1177/01455613211069344","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>With the global COVID-19 pandemic, nasopharyngeal swabbing has become commonplace and can occasionally cause discomfort, tearing, and anxiety.</p><p><strong>Objective: </strong>To evaluate whether using a neural distraction device during nasopharyngeal swabbing can mitigate patient discomfort.</p><p><strong>Methods: </strong>Participants were randomized into nasal swab with vibration first (treatment-control or Tc) or nasal swab without vibration first (control-treatment or Ct). Then the swab was repeated with the opposite technique. The vibration device was used to stimulate the infraorbital nerve at the midpupillary line, while a nasopharyngeal swab was performed according to CDC protocol. After each swab, participants filled out a survey to assess pain, discomfort, and tearing. This procedure was replicated on the contralateral nostril for a total of 4 swabs and 4 surveys.</p><p><strong>Results: </strong>Thirty-four subjects were included in the analysis. In the Ct group, there was a median 1.0-point decrease in pain with the use of vibration (95% CI [-1.8, -0.3]<u>,</u> <i>P</i> = 0.0117), 2.5-point decrease (95% CI [-3.0, -0.8], <i>P</i> = 00039) in discomfort, and a 1.0-point decrease (95% CI [-2.6, -0.2] <i>P</i> = 0.0303) in tearing when the vibratory device was used. In the Tc group, there was a median 2.0-point decrease in pain with vibration (95% CI [ -2.7, -1.1], <i>P</i> < 0.0001), 2.3-point decrease in discomfort (95% CI [-3.1, -1.5], <i>P</i> < 0.0001), and a 1.5-point decrease in tearing (95% CI [-2.5, -0.5], <i>P</i> = 0.0037) when vibration was used.</p><p><strong>Conclusion: </strong>Vibratory stimulation of the infraorbital nerve is safe and effectively reduced pain, discomfort, and tearing during nasopharyngeal swab. Vibration is a reasonable option to minimize patient discomfort during COVID-19 or other microbiological testing.</p>","PeriodicalId":51041,"journal":{"name":"Ent-Ear Nose & Throat Journal","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ent-Ear Nose & Throat Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/01455613211069344","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: With the global COVID-19 pandemic, nasopharyngeal swabbing has become commonplace and can occasionally cause discomfort, tearing, and anxiety.
Objective: To evaluate whether using a neural distraction device during nasopharyngeal swabbing can mitigate patient discomfort.
Methods: Participants were randomized into nasal swab with vibration first (treatment-control or Tc) or nasal swab without vibration first (control-treatment or Ct). Then the swab was repeated with the opposite technique. The vibration device was used to stimulate the infraorbital nerve at the midpupillary line, while a nasopharyngeal swab was performed according to CDC protocol. After each swab, participants filled out a survey to assess pain, discomfort, and tearing. This procedure was replicated on the contralateral nostril for a total of 4 swabs and 4 surveys.
Results: Thirty-four subjects were included in the analysis. In the Ct group, there was a median 1.0-point decrease in pain with the use of vibration (95% CI [-1.8, -0.3],P = 0.0117), 2.5-point decrease (95% CI [-3.0, -0.8], P = 00039) in discomfort, and a 1.0-point decrease (95% CI [-2.6, -0.2] P = 0.0303) in tearing when the vibratory device was used. In the Tc group, there was a median 2.0-point decrease in pain with vibration (95% CI [ -2.7, -1.1], P < 0.0001), 2.3-point decrease in discomfort (95% CI [-3.1, -1.5], P < 0.0001), and a 1.5-point decrease in tearing (95% CI [-2.5, -0.5], P = 0.0037) when vibration was used.
Conclusion: Vibratory stimulation of the infraorbital nerve is safe and effectively reduced pain, discomfort, and tearing during nasopharyngeal swab. Vibration is a reasonable option to minimize patient discomfort during COVID-19 or other microbiological testing.
期刊介绍:
Ear, Nose & Throat Journal provides practical, peer-reviewed original clinical articles, highlighting scientific research relevant to clinical care, and case reports that describe unusual entities or innovative approaches to treatment and case management. ENT Journal utilizes multiple channels to deliver authoritative and timely content that informs, engages, and shapes the industry now and into the future.