A double‐blind randomised controlled trial assessing the efficacy of topical lidocaine in extended flexible endoscopic nasal examinations
Bibliographic record
Abstract
OBJECTIVE: To test the hypothesis that using lidocaine nasal spray will result in improved pain and comfort outcomes during an extended flexible endoscopic nasal examination. DESIGN: A split-body, double-blind, placebo-controlled randomised trial. After receiving a rinse of oral mouthwash (Listerine(®)), patients were randomised to receive placebo in one nasal cavity and 30 mg of topical lidocaine in the other. SETTING: A tertiary care centre outpatient Otolaryngology clinic. PARTICIPANTS: Twenty-two patients who required an extended bilateral flexible endoscopic nasal examination. An extended nasal examination consisted of an examination of a minimum of two osteomeatal regions on each side of the nasal cavity. MAIN OUTCOME MEASURES: Discomfort and pain were assessed using a 100-mm Visual Analogue Scale (VAS). Our study utilised the definition of pain based on International Association for the Study of Pain. Pain was defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Discomfort was defined as the overall unpleasant experience of the procedure. This included all aspects of the examination such as the pain or other negative sensations associated with the examination, any side effects associated with the application of the nasal sprays as well as any anxiety associated with the examination. A Wilcoxon sign-rank test was used for the primary outcome measures. RESULTS: There was a significant reduction in discomfort scores on the treatment side of the nasal cavity compared with the control side (median VAS score of 18.6 mm versus 44.6 mm; P = 0.01). The change in pain between the treatment side compared with the control side did not reach our definition of statistical significance (5.1 mm versus 9.2 mm; P = 0.05). Patients with an active or uncontrolled inflammatory disorder of the nasal cavity experienced a significantly greater reduction in pain compared to those without an inflammatory condition (median change of the VAS score, -15.6 versus +1.0; P = 0.01). CONCLUSIONS: After a rinse with oral mouthwash, the use of lidocaine results in a significant reduction in the discomfort associated with an extended bilateral flexible endoscopic nasal examination. Patients undergoing such an examination would benefit from the application of lidocaine after masking the negative flavour using oral mouthwash.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".