Lignocaine versus benzocaine as a topical nasal anesthetic

Abstract

Problem: The effectiveness of 10% lidocaine compared with benzocaine 20% spray in reducing pain perceived by patients undergoing flexible nasolaryngoendoscopy in the ENT clinic was evaluated in a randomized double-blind placebo-controlled study. In addition, patient acceptance of both sprays with reference to taste, smell, and acceptability was evaluated. Methods: Fifty randomly selected subjects undergoing flexible nasolaryngoendoscopy in the ENT clinic were randomly treated with 10% lidocaine spray or 20% benzocaine spray. A nurse in a separate room sprayed the patient and a doctor performed the flexible nasolaryngoendoscopy procedure after 5 minutes had elapsed. Demographic data were collected from the patients: age, sex, and whether they were smokers or nonsmokers. Patients recorded on a form their perception of the pain perceived while the spray was being delivered, of the procedure itself, and of acceptability, taste, and smell on a visual analogue scale. Results: We found that with respect to pain perceived on delivery of the sprays, lignocaine (Xylocaine) was significantly more painful then benzocaine (Hurricaine) with P < 0.05. In reducing the pain of the procedure itself, there was no significant difference between the 2. With respect to taste, smell, and acceptability, benzocaine did significantly better than xylocaine, P < 0.05. There was no significant difference when results were compared with reference to age, sex, or whether one was a smoker. Conclusion: Benzocaine is better tolerated than Lignocaine as a topical intranasal local anesthetic spray. Significance: When possible, choose benzocaine over lignocaine as a topical nasal anesthetic spray. Support: None reported.