Compare the ease of performing transnasal flexible laryngoscopy using different topical preparations and methods of application

Asha, K Joy (2018) Compare the ease of performing transnasal flexible laryngoscopy using different topical preparations and methods of application. Masters thesis, Christian Medical College, Vellore.


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BACKGROUND AND OBJECTIVES: Flexible Fibreoptic Nasopharyngolaryngoscopy (NPL) is a very common procedure in outpatient and inpatient setting and is performed to evaluate the upper aerodigestive tract. Various agents are being used to decrease patient discomfort and facilitate a smooth examination. However, consensus regarding the best agent to use, if any, does not exist. AIMS AND OBJECTIVES: Our objective was to compare the effectiveness of topical agents used during NPL in: 1. Relieving pain and discomfort during the procedure. 2. Improving introduction and advancement of endoscope. 3. Facilitating a complete examination. METHODOLOGY: This was a prospective randomized open label trial conducted over one year. Subjects referred for NPL were recruited with convenient sampling (based on inclusion and exclusion criteria) and then randomized into one of the 4 arms [10% lignocaine spray, 2% lignocaine gel, 4%lignocaine solution with xylometazoline (1:1) pledgets and non-medicated water based gel]. They were assessed utilizing a previously used questionnaire for comfort of the procedure (10 points by the patients) and for the ease of examination (4 points by the doctors). RESULTS: A total of 376 patients were recruited into the study. There was no difference (p value = non significant) in any of the discomfort parameters (overall pain, burning after application, nasal pain, throat pain, gagging, unpleasant taste, foreign body sensation in the throat, trouble swallowing or breathing and level of willingness to undergo the test again) between the groups. There was also no difference with regards to ease of performing the procedure and quality of view between the four groups. CONCLUSION: As there was no significant difference between the four groups in reducing patient discomfort and facilitating an adequate examination, non-medicated water based gel can be considered an effective agent for performing Flexible Fibreoptic Nasopharyngolaryngoscopy.

Item Type: Thesis (Masters)
Additional Information: Reg.No: 221514351
Uncontrolled Keywords: ease of performing ; transnasal flexible laryngoscopy ; different topical preparations ; methods of application.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 15 Jul 2018 09:39
Last Modified: 15 Jul 2018 09:39

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