2% Lidocaine Spray vs. 2% Lidocaine Viscous for Head and Neck Cancer with Chemoradiation Mucositis

The use of 2% lidocaine oral viscous is constrained by its inconvenience of portability, coupled with difficulty swallowing in some cases, and its unpleasant taste. This study aimed to compare the effects of 2% peppermint lidocaine spray with conventional 2% lidocaine oral viscous on the immediate pain reduction score at baseline and 5 minutes, feasibility, and quality of life in head and neck cancer patients with chemoradiation-induced mucositis.

This study was an open-label randomized controlled trial. The patients were randomized using a block of four and divided into two groups. A research nurse collected data on pain scores and quality of life using the modified Oral Mucositis Weekly Questionnaires-Head and Neck Cancer (OMWQ-HN) (Supplement 1) In addition, the nurse monitored the use of the product by approaching patients every Friday of each week until the end of the radiation course. Randomization was performed using computer-generated blocks of four prepared by an independent statistician. Allocation concealment was maintained using sealed opaque envelopes.

A total of 60 patients, patients in the 2% peppermint lidocaine spray group had significantly better scores on the OMWQ-HN-12 items and found it more practical to use and with a better flavor compared to the 2% lidocaine viscous group. The immediate reduction in pain did not differ between the groups. Therefore, we conclude that 2% peppermint lidocaine spray promotes better satisfaction and quality of life without compromising pain control in patients with head and neck cancer with chemoradiation induced mucositis.

The 2% peppermint lidocaine spray did not demonstrate significantly better immediate pain reduction compared to 2% viscous lidocaine, but did improve the global quality of life in patients with head and neck cancer with chemoradiation-induced mucositis.