Moffett's Solution Causes Significantly Greater Postoperative Throat Pain Compared to Cophenylcaine in Sinonasal Surgery.

Dominic Ku,Narinder Pal Singh,Kartik Vasan,Evan Tseros,Eugene Wong

doi:10.1155/2019/3738647

Abstract

Aim Preoperative decongestion with Moffett's solution is routine practice in sinonasal procedures providing an ideal operative field. Anecdotally, it is related to postoperative throat pain, yet a quantitative relationship has not been established. We compare the incidence and severity of postoperative throat pain after application of Moffett's solution against Cophenylcaine decongestion. Methodology A total of thirty patients from two consultants were recruited. The intervention arm (twenty) was decongested with Moffett's solution and the control arm (ten) with Cophenylcaine. The primary outcome was self-reported postoperative throat pain as measured by visual analogue scale (VAS) at 2 hours, 4 hours, 6 hours, and next morning. Results There was a significantly higher VAS for throat pain in patients decongested with Moffett's solution in the early postoperative period (2 hours p=0.03, 4 hours p=0.04). Conclusion Moffett's solution is associated with a greater severity of transient postoperative throat pain compared to topical Cophenylcaine. We recommend further studies to identify means to minimise this side effect. Clinical Trial Registration This paper has been registered with the Australian and New Zealand Clinical Trials Registry under the registration number: ACTRN12619000772145.

Highlights

Moffett’s solution is commonly used as a topical decongestant and local anaesthetic in sinonasal surgery
(iv) This study shows that the use of Moffett’s solution when compared to Cophenylcaine in preparation of sinonasal surgery is associated with increased postoperative throat pain up to 4 hours postoperatively
The solution was administered via the MADgic atomiser, which allows the solution to be distributed as a fine mist, effectively reaching most exposed surfaces of the nasal mucosa

Summary

Introduction

Moffett’s solution is commonly used as a topical decongestant and local anaesthetic in sinonasal surgery. When applied topically to the nasal mucosa, it produces profound vasoconstriction and anaesthesia, reducing blood loss and improving visualisation in the operative field for sinonasal surgery [2, 3]. This combination of constituents has been shown to have greater efficacy than any of the individual components alone, and it has been noted to have an excellent safety profile when administered topically to the nasal mucosa in the prescribed manner [3,4,5]

Methods

Results

Conclusion