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The physiologic impact of transnasal flexible endoscopy
Author(s) -
Ongkasuwan Julina,
Yung Katherine C.,
Courey Mark S.
Publication year - 2012
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23358
Subject(s) - medicine , lidocaine , blood pressure , vital signs , heart rate , anesthesia , endoscopy , prospective cohort study , otorhinolaryngology , surgery
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.