Co-phenylcaine as an alternative to Brompton's solution in rigid nasendoscopy: a pilot study

Rigid nasendoscopy is a diagnostic aid that is frequently used in otorhinolaryngology clinics. Topical local anaesthetic and vasoconstriction is advised prior to the procedure. Options include both Brompton's solution and co-phenylcaine. Brompton's solution contains 10% cocaine, a controlled drug that has potentially serious side-effects. Even deaths have been reported as a consequence of its use as a nasal preparatory agent.

To compare the efficacy of cocaine in the form of Brompton's solution versus co-phenylcaine as both a vasoconstrictor and a local anaesthetic in out-patient diagnostic rigid nasendoscopy.

Thirty-three patients awaiting diagnostic rigid nasendoscopy were recruited to the study. Each patient served as his own control. Co-phenylcaine was delivered as a metered dose of two sprays to one nasal passage and Brompton's solution was delivered on a cotton wool pledget placed in the other nasal passage with the aid of Tilly's forceps. An endoscopist who was unaware of which nasal passage was treated with which agent scored the vasoconstricion at endoscopy 10 min after drug application using a scoring sheet. The patients gave a numerical assessment of how painful the procedure was for each nasal passage. Mean scores were compared using Student's t-test.

There was no difference between the two agents with regard to nasal analgesia and vasoconstriction during rigid nasal endoscopy.