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

McCluney, Neil; Eng, Chee-Yean; Lee, M S W; McClymont, Leo G.

doi:10.1017/s0022215108003666

Cited by 13 publications

(15 citation statements)

References 9 publications

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“…In contrast, other studies have investigated the use of a sole vasoconstrictor or decongestant. Xylometazoline is a cheap decongestant with few side‐effects, although not as efficacious as anaesthetic alone, and can be used to improve tolerance and ease of procedure by widening the nasal aperture …”

Section: Discussionmentioning

confidence: 99%

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Saif

Farboud

Delfosse

et al. 2016

Clinical Otolaryngology

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For operative procedures, such as septorhinoplasty, a single agent tetracaine or levobupivicaine provides an improved surgical field. In functional endoscopic sinus surgery, lidocaine-adrenaline preparations have resulted in significantly better surgical and patient outcomes. There is little evidence to support the routine use of pre-procedural nasal preparation for flexible nasendoscopy. Those undergoing rigid endoscopy conversely always require the use of a vasoconstrictor and local anaesthetic. Pre-procedure assessment of patients is recommended, with agents being reserved for those with low pain thresholds, high anxiety and small nasal apertures presenting resistance to the insertion of the endoscope.

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Section: Discussionmentioning

confidence: 99%

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Saif

Farboud

Delfosse

et al. 2016

Clinical Otolaryngology

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“…Topical nasal vasoconstriction with oxymetazoline is considered to have similar or greater efficacy and less toxicity (hypertension, tachycardia) compared with phenylephrine, epinephrine, and cocaine, especially in children . Thus, it is a frequently used topical vasoconstrictor in intubations and surgeries involving the nasal passages and is often considered by clinicians to be a benign drug.…”

Section: Discussionmentioning

confidence: 99%

Oxymetazoline and hypertensive crisis in a child: can we prevent it?

Latham

Jardine

2013

Pediatric Anesthesia

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“…We only compared 4% cocaine to 0.5% phenylephrine. However, recent trials have shown promising results of 2% tetracaine in combination with epinephrine,[18] 0.1% xylometazoline[19] and 0.05% oxymetazoline[20] as nasal decongestants. Thus, future research should be directed at comparing all these agents side by side in a randomised fashion with a well-planned comparative analysis.…”

Section: Discussionmentioning

confidence: 99%

Phenylephrine as an alternative to cocaine for nasal vasoconstriction before nasal surgery: A randomised trial

AlHaddad

Khanna²,

Mascha³

et al. 2013

Indian J Anaesth

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Background:Cocaine is often used topically to provide the profound vasoconstriction required for nasal surgery; however, it has been associated with intraoperative cardiac adverse effects. We compared cocaine with phenylephrine as an alternative to ascertain their relative efficacy as vasoconstrictors in nasal septoplasty.Methods:Adult patients, presenting for elective nasal septoplasty, of American Society of Anaesthesiologists physical status I-III, were randomised to either 0.5% phenylephrine or 4% cocaine. The primary outcome was quality of vasoconstriction on a 5-point scale (1=unacceptable, 5=excellent), rated by the surgeon at the end of the procedure.Results:Twenty-nine patients received phenylephrine and 26 received cocaine. The median rating for quality of the vasoconstriction was 4.0 (good) in both the phenylephrine and cocaine groups (P=0.84). Median blood loss was 50 ml in the phenylephrine group and 62.5 ml in the cocaine group (P=0.49). In secondary analyses, phenylephrine was shown to be non-inferior to cocaine on both quality of vasoconstriction (non-inferiority delta of 1 point, P=0.009) and estimated blood loss (non-inferiority delta of 25 ml, P=0.028). The frequency of ventricular ectopy, ST segment changes or blood pressure changes after nasal packing was not significantly different between the two groups.Conclusion:Phenylephrine in a concentration of 0.5% is not different from 4% cocaine on the quality of vasoconstriction in septoplasty. Given the abuse potential of cocaine and the added administrative burden associated with its handling, phenylephrine might serve as an alternative.

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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

Cited by 13 publications

References 9 publications

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Assessing the safety and efficacy of drugs used in preparing the nose for diagnostic and therapeutic procedures: a systematic review

Oxymetazoline and hypertensive crisis in a child: can we prevent it?

Phenylephrine as an alternative to cocaine for nasal vasoconstriction before nasal surgery: A randomised trial

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