COCAINE OR PHENYLEPHRINE LIGNOCAINE FOR NASAL FIBEROPTIC INTUBATION/

In order to assess if a mixture of phenylephrine/lignocaine is as effe ctive as cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation, 99 patients receiving topical nasal analgesia either with cocaine 10% or a mixture of phenylephrine 1% and lignocain e 4% were studied in a randomized double-blind investigation. After to pical analgesia a flexible fibreoptic endoscope was advanced through a nostril. Larynx, glottis and trachea were endoscopically sprayed with lignocaine. Following induction of anaesthesia a nasotracheal tube wa s inserted fibreoptically. Pain intensity and amount of epistaxis duri ng endoscopy were assessed. Blood pressure, heart rate and EGG-ST segm ent were determined before and after topical nasal analgesia, after in duction of anaesthesia and after nasotracheal intubation. There were n o significant differences in pain intensity or epistaxis between group s during endoscopy, nor significant alterations in haemodynamic parame ters or ST-segment. it is concluded that the mixture of phenylephrine and lignocaine is a useful alternative to cocaine for local analgesia and vasoconstriction during nasal fibreoptic intubation.