Nasal anaesthetic spray helps reduce anxiety, pain during surgery: Study

Mumbai: A modified nasal spray could help reduce anxiety and pain in adults undergoing certain medical procedures, as per a prospective study conducted by a city hospital.The intranasal spray contained medicines commonly used by anaesthetists, such as ketamine, midazolam and lignocaine, to sedate patients and reduce pain associated with surgeries. The study, conducted from July 2023-June 2024, was recently published in International Journal of Clinical Anesthesia and Research.Over 300 adults scheduled for gastrointestinal endoscopy at H N Reliance Hospital, Girgaum, were enrolled into two groups: a control group received standard sedation via IV drip and the test group got pre-operative medications through the intranasal spray. "The intranasal drug delivery system achieved better pain control, mobility and lower post-operative anxiety versus the intravenous procedural sedation group," said author Dr Misha Mehta. "When patients are brought to the OT, they are anxious—for the first time, they are away from their family and they are also worried about the instruments in the OT. This spray puts them in a trance-like sleep from which they can awaken when spoken to," said senior author and anaesthesiologist Dr Hemant Mehta. An article in Anesthesiology and Perioperative Science in Jan 2025 said: "The rapid advancement of AI has facilitated the emergence of automated anaesthesia systems, significantly enhancing the precision, efficiency, and adaptability of anaesthesia management in complex surgical environments." The intranasal anaesthetic spray is a step in this direction; the team administered the spray to patients before surgery, and then at four-hour intervals. "Patients feel anxious about IV medications. The nasal spray eliminated that fear and post operation, they didn't have symptoms such as vomiting," said the doctors. Additional professor Dr Ashish Mali from BMC-run Nair Hospital said such sprays could help with anxiety but may not be enough for sedation. "Sedation dosages depend on the kind of surgery being performed." A pre-operative IV drug as anaesthesia is preferred in case a patient's blood pressure drops during surgery and doctors scramble to find blood vessels. "Also, nasal sprays, while convenient, may not be suitable for all patients. It may be useful for dentistry, in paediatric patients, and certain non-invasive procedures like a long MRI scan or endoscopy," said Dr Mali.