Ongkasuwan J, Yung KC, Courey MS. The physiologic impact of transnasal flexible endoscopy.
Laryngoscope 2012;
122:1331-4. [PMID:
22499435 DOI:
10.1002/lary.23358]
[Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 03/26/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVES/HYPOTHESIS
Diagnostic transnasal flexible endoscopy (TNFE) is a commonly used office procedure in otolaryngology. Currently there is a paucity of data on the impact of TNFE on physiologic parameters. This is relevant with the advent of office-based endoscopic procedures. The goal of this study is to measure the impact of topical decongestion, anesthesia, and diagnostic TNFE on vital signs: systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), and oxygenation (O(2) sat).
STUDY DESIGN
Prospective case control study, in which the patient is his/her control.
METHODS
Vital signs were obtained at baseline, immediately after the application of Neosynephrine, after the application of lidocaine, 5 minutes later, with the scope in the nasopharynx and hypopharynx, and upon completion of the procedure.
RESULTS
Compared to the baseline data, there was a statistically significant increase in HR after the procedure (mean change, 4.06 ± 10.15 bpm; range, -14 to 42 bpm, P = .01). There was also a change in O(2) sat (mean change, 0.42% ± 1.36%; range -3% to 3%, P = .03) after the application of lidocaine. When comparing each data point to the preceding point, there was a statistically significant change in SBP with the scope in the nasopharynx (mean change, 5.34 ± 10.65 mm Hg; range, -22 to 28 mm Hg, P = .001) and in HR with the scope in the hypopharynx (mean change, 3.76 ± 6.41 bpm; range, -9 to 19 bpm, P = .0004).
CONCLUSIONS
Diagnostic TNFE and topical lidocaine can have an impact on physiologic parameters; however, these changes are unlikely to be clinically significant.
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