Lidocaine/Phenylephrine Nasal Spray versus Nebulization Prior to Nasoendoscopy: A Randomized Controlled Trial

Area of Science:

• Otolaryngology
• Pharmacology
• Medical Devices

Background:

• Chronic rhinitis often requires nasal decongestion for effective examination.
• Lidocaine/phenylephrine is a common agent for nasal decongestion.
• Delivery methods may impact drug efficacy.

Purpose of the Study:

• To compare the nasal decongestion potency of lidocaine/phenylephrine delivered via nasal nebulizer versus nasal spray.
• To assess the analgesic effects of each delivery method.
• To evaluate efficacy prior to rigid nasoendoscopic examination.

Main Methods:

• An open-label, randomized controlled trial with 106 participants with chronic rhinitis.
• Lidocaine/phenylephrine (400 μL) administered to the right nostril via nebulizer (n=53) or spray (n=53).
• Nasal resistance measured by active anterior rhinomanometry; pain assessed subjectively.

Main Results:

• Nasal nebulizer group showed greater reduction in nasal resistance compared to nasal spray.
• Statistically significant differences in nasal resistance at 5, 15, and 30 minutes post-intervention.
• Nebulizer use resulted in significantly lower pain scores and improved endoscopic assessment of decongestion.

Conclusions:

• Nasal nebulizer delivery of lidocaine/phenylephrine offers superior decongestive and analgesic effects compared to nasal spray.
• This method enhances preparation for nasoendoscopic procedures.
• Nebulization represents a more effective delivery system for this combination agent.