• N A McCluney, C Y Eng, M S W Lee, and L G McClymont.
• Department of Otolaryngology/Head and Neck Surgery, Raigmore Hospital, Inverness, Scotland, UK. neilmccluney@doctors.org.uk
• J Laryngol Otol. 2009 Jun 1; 123 (6): 626-30.

ObjectiveTo evaluate if phenylephrine-lignocaine mixture (Cophenylcaine) nasal spray performs better than xylometazoline (Otrivine) spray for the purposes of out-patient rigid nasendoscopy preparation.DesignProspective, double-blind, randomised trial comparing visual analogue scores for out-patients receiving either phenylephrine-lignocaine mixture or xylometazoline, prior to undergoing rigid nasendoscopy as part of their assessment.SubjectsSeventy-three patients requiring rigid nasendoscopy as part of their assessment were recruited to the study from Raigmore Hospital's out-patient clinic. These patients were randomised to receive a nasal spray comprising either phenylephrine-lignocaine mixture or xylometazoline, 10 minutes prior to rigid nasendoscopy. Double-blinding was adopted. After the procedure, the patient and the doctor independently completed separate visual analogue score-based questionnaires regarding the pain of the procedure and the ease of the examination, respectively.ResultsAnalysis of the data using standardised statistical methods demonstrated that the phenylephrine-lignocaine mixture did not perform better than xylometazoline, to any statistically significant extent.ConclusionPhenylephrine-lignocaine mixture is considerably more expensive and has potentially more side effects than xylometazoline. These study findings suggest that it is difficult to justify the use of phenylephrine-lignocaine mixture over xylometazoline, for nasal preparation prior to rigid nasendoscopy.

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