Does Patient Position Affect Administration of Intranasal Agents?

A concern with squeeze-bottle atomizers that administer intranasal medications is that they cannot ensure delivery of precise amounts of agents such as vasoconstrictors and local anesthetics, and, as a result, they may cause inadvertent overdosing and subsequent hypertension, intracranial hemorrhage, or pulmonary edema.

To determine if patient position affects the volume of liquid delivered by these devices, 10 anesthesia residents experienced in intranasal-medication administration were asked to squeeze water from a 25-mL atomizer (similar to pharmacy-supplied squeeze bottles containing phenylephrine and aqueous lidocaine) into the nostril of a mannequin placed in several head positions (0, 15, 30, 45, and 90 degrees). In addition, several …