Finding a better nasal anaesthetic: the efficacy of tetracaine and oxymetazoline as a topical nasal anaesthetic and decongestant

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Cophenylcaine (a combination of lignocaine and phenylephrine, a local anaesthetic and decongestant respectively) is commonly used as a spray to make the inside of the nose numb in Otolaryngology (ear, nose and throat surgery) clinics. However, other local anaesthetics like tetracaine are more potent than lignocaine, and phenylephrine tastes very bitter whereas other decongestants like oxymetazoline are essentially tasteless. Our hypothesis is that a tetracaine/oxymetazoline spray will act more quickly and give better anaesthesia to the inside of the nose than cophenylcaine. We will test cophenylcaine and three different concentrations of tetracaine/oxymetazoline in ten healthy participants. We will give them two sprays of one anaesthetic/decongestant in one nostril, and two sprays of another anaesthetic/decongestant in the other nostril, and measure the sensation of the lining of the nose at regular intervals using fine hair-like filaments designed for this purpose. Then, we will do the same thing with the other two anaesthetic/decongestants at least one day later, so that all participants will receive all four anaesthetic/decongestants. This will show clearly whether tetracaine/oxymetazoline gives better nasal anaesthesia than cophenylcaine, and if so, which concentration of tetracaine is best for this purpose.

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