A Comparison of xylometazoline (Otrivine) and phenylephrine/lignocaine mixture (Cophenylcaine) for the purposes of rigid nasendoscopy: a prospective, double-blind, randomised trial

Abstract

AbstractObjective:To evaluate if phenylephrine–lignocaine mixture (Cophenylcaine) nasal spray performs better than xylometazoline (Otrivine) spray for the purposes of out-patient rigid nasendoscopy preparation.Design:Prospective, 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.Subjects:Seventy-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.Results:Analysis of the data using standardised statistical methods demonstrated that the phenylephrine–lignocaine mixture did not perform better than xylometazoline, to any statistically significant extent.Conclusion:Phenylephrine–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.