Study Examines Discomfort in Children Undergoing Flexible Nasendoscopy

Three kinds of nasal sprays were no different in their effects on discomfort experienced by children undergoing nasendoscopy, a procedure in which a fiberoptic endoscope is inserted through the nose so a physician can examine the nasal cavity and inside the throat, according to a study by Neil K. Chadha, M.B.Ch.B., M.P.He. B.Sc., F.R.C.S, of the British Columbia Children’s Hospital, Vancouver, Canada, and colleagues.

To minimize discomfort, many otolaryngologists typically administer a nasal spray, usually a decongestant with or without a topical local anesthetic (TLA) before the procedure. However, the actual benefits of these sprays are unclear, according to the study background.

Researchers conducted a randomized trial with 69 children to compare pain from the procedure after using one of three nasal sprays: placebo, a decongestant with a TLA or a decongestant without a TLA. The main outcome measure was child-reported pain using a standardized scale.

The study reports no statistically significant difference in the discomfort experienced by children who received the three sprays, although discomfort scores were less with decongestant without a TLA, according to the study findings.

“With these findings, the study suggest that there is no significant benefit of topical decongestant with or without TLA compared with placebo in reducing pain associated with pediatric flexible nasendoscopy,” the study concludes.

(JAMA Otolaryngol Head Neck Surg. Published online October 24, 2013. doi:10.1001/jamaoto.2013.5297.