Topical lidocaine anesthesia for nasopharyngeal sampling – a double-blind randomized placebo-controlled trial

Authors

DOI:

https://doi.org/10.15584/ejcem.2022.1.8

Keywords:

COVID-19 testing, lidocain, nasopharynx, swab

Abstract

Introduction and aim. The aim of this study is to evaluate the effects of topical lidocaine application for nasopharyngeal sampling, on pain perception, the comfort of the patients, and the application difficulty for healthcare staff.

Material and methods. This study conducted with 100 healthy volunteers (50 participants in Lidocaine group and 50 participants in Placebo group). Two ml of a solution containing 10 mg/ml of lidocaine was applied to each nostril of the participants in the Lidocaine group, and the same dose of 0.9% NaCl to the Placebo group. We compared the changes in pain intensity and discomfort intensity using two numerical rating scales, the frequency of undesirable reactions, and the judgment of the practitioner staff.

Results. There were statistically significant decreases in pain and discomfort scores in the Lidocaine group. Similarly, there were statistically significant decreases in the frequency of all undesirable reactions except “grimace”, in the second sampling in the Lidocaine group, however, there was a statistically significant decrease only in “holding staff’s hand” in second sampling in the Placebo group.

Conclusion. Intranasal lidocaine application reduces the pain that occurs during nasopharyngeal sampling and makes the procedure easier for the patient and the healthcare worker.

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References

Niforatos JD, Chaitoff A, Zheutlin AR, Feinstein MM, Raja AS. Barriers to emergency department usage during the COVID-19 pandemic. J Am Coll Emerg Physicians Open. 2020;1:1261-1268.

Pines JM, Zocchi MS, Black BS, et al. The effect of the COVID-19 pandemic on emergency department visits for serious cardiovascular conditions. Am J Emerg Med. 2021;47:42-51.

Nourazari S, Davis SR, Granovsky R, et al. Decreased hospital admissions through emergency departments during the COVID-19 pandemic. Am J Emerg Med. 2021;42:203-210.

Carpenter CR, Mudd PA, West CP, Wilber E, Wilber ST. Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Examinations, Laboratory Tests, Imaging Accuracy, and Biases. Acad Emerg Med. 2020;27:653-670.

Tolia VM, Chan TC, Castillo EM. Preliminary Results of Initial Testing for Coronavirus (COVID-19) in the Emergency Department. West J Emerg Med. 2020;21:503-506.

Mehta N, Mazer-Amirshahi M, Alkindi N, Pourmand A. Pharmacotherapy in COVID-19; A narrative review for emergency providers. Am J Emerg Med. 2020;38:1488-1493.

Petruzzi G, De Virgilio A, Pichi B, et al. COVID-19: Nasal and oropharyngeal swab. Head Neck. 2020;42:1303-1304.

Tsujimoto Y, Terada J, Kimura M, et al. Diagnostic accuracy of nasopharyngeal swab, nasal swab and saliva swab samples for the detection of SARS-CoV-2 using RT-PCR. Infect Dis (Lond). 2021:1-9.

Zedtwitz-Liebenstein K. Correctly performed nasal swabs. Infection. 2021:1-2.

Föh B, Borsche M, Balck A, et al. Complications of nasal and pharyngeal swabs - a relevant challenge of the COVID-19 pandemic? Eur Respir J. 2021;57(4):2004004.

McElfish PA, Purvis R, James LP, Willis DE, Andersen JA. Perceived Barriers to COVID-19 Testing. Int J Environ Res Public Health. 2021;18(5):2278.

Brandt MP, Jäger W, Epple S, Haferkamp A, Schröder A. SARS-CoV-2 outbreak in medical employees in a large urologic department: Spread, containment and outcome. Am J Infect Control. 2021;49:674-677.

Pasomsub E, Watcharananan SP, Boonyawat K, et al. Saliva sample as a non-invasive specimen for the diagnosis of coronavirus disease 2019: a cross-sectional study. Clin Microbiol Infect. 2021;27:285.e1-.e4.

Yu X, Wang J, Huang L, Yu X, He Z. Efficacy and safety of bupivacaine versus lidocaine in local anesthesia of the nasopharynx: A meta-analysis. Am J Rhinol Allergy. 2016;30:176-180.

Özkiriş M, Aydin R, Gencer ZK, Saydam L. Comparison of topical anesthetic effects of lidocaine, prilocaine, ropivacaine, and bupivacaine in transnasal fiberoptic nasopharyngolaryngoscopy. Am J Rhinol Allergy. 2014;28:e141-e143.

Kanodia A, Srigyan D, Sikka K, et al. Topical lignocaine anaesthesia for oropharyngeal sampling for COVID-19. Eur Arch Oto-Rhino-Laryngol. 2021;278:1669-1673.

Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol. 2004;4:26.

Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332.

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-191

Vandenberg O, Martiny D, Rochas O, van Belkum A, Kozlakidis Z. Considerations for diagnostic COVID-19 tests. Nat Rev Microbiol. 2021;19:171-183.

World Health Organization. Diagnostic testing for SARS-CoV-2: interim guidance, 11 September 2020. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/334254/WHO-2019-nCoV-laboratory-2020.6-eng.pdf. Accessed 20 March 2021.

Centers for Disease Control and Prevention. Interim Guidelines for Collecting and Handling of Clinical Specimens for COVID-19 Testing. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html. Accessed 20 March 2021.

Bwire GM, Majigo MV, Njiro BJ, Mawazo A. Detection profile of SARS-CoV-2 using RT-PCR in different types of clinical specimens: A systematic review and meta-analysis. J Med Virol. 2021;93:719-725.

Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382:1177-1179.

Butler-Laporte G, Lawandi A, Schiller I, et al. Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARS-CoV-2: A Systematic Review and Meta-analysis. JAMA Intern Med. 2021;181:353-360.

Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020;395:1973-1987.

Chi PW, Hsieh KY, Chen KY, et al. Intranasal lidocaine for acute migraine: A meta-analysis of randomized controlled trials. PLoS One. 2019;14:e0224285.

Covino BG, Giddon DB. Pharmacology of local anesthetic agents. J Dent Res. 1981;60:14549.

Dickerson DM, Apfelbaum JL. Local Anesthetic Systemic Toxicity. Aesthet Surg J. 2014;34:1111-1119.

Neal JM, Barrington MJ, Brull R, et al. The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine: Executive Summary 2015. Reg Anesth Pain Med. 2015;40:401-430.

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Published

2022-03-30

How to Cite

Tekyol, D., Akbas, I., Dogruyol, S., Kocak, A. O., & Çakır, Z. (2022). Topical lidocaine anesthesia for nasopharyngeal sampling – a double-blind randomized placebo-controlled trial. European Journal of Clinical and Experimental Medicine, 20(1), 56–62. https://doi.org/10.15584/ejcem.2022.1.8

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ORIGINAL PAPERS