Cocaine or phenylephrine/lignocaine for nasal fibreoptic intubation?

Comparison of two different techniques of fibreoptic intubation

“…Thirty minutes prior to induction of anaesthesia, a 1 ml mixture of lidocaine 2% with phenylephrine 0.25% was applied into each nostril [8]. After documentation of the patient's age, height, and weight, the standard monitoring, including electrocardiography, noninvasive blood pressure, and arterial oxygen saturation was initiated.…”

Topical vasoconstrictor use for nasal intubation during pregnancy complicated by cardiomyopathy and preeclampsia

“…[9][10][11] In an eclamptic patient, a single report of nasal preparation with a lidocaine-phenylephrine mix (4% lidocaine 3 mL + phenylephrine 0.5 mL + saline 0.5 mL) and intubation described unchanged maternal blood pressures (systolic 150-160 mmHg and diastolic 95-100 mmHg) before and after intubation, and no epistaxis in spite of thrombocytopenia. 12 The venous sinuses of the nose are capable of significant engorgement during pregnancy.…”

A Simple Technique to Reduce Epistaxis and Nasopharyngeal Trauma During Nasotracheal Intubation in a Child with Factor IX Deficiency Having Dental Restoration

“…Topical vasoconstrictors, such as cocaine and ␣-adrenergic agonists (phenylephrine, xylometazoline, and oxymetazoline), reduce epistaxis in similar amounts (2,10,11). The use of vasoconstrictors has been associated with cardiac arrest and dangerous arrhythmias in children (12,13), as well as central nervous system stimulation, hypertension, and stroke (13).…”