Related Experiment Videos
Topical lidocaine for postoperative analgesia following myringotomy and tube placement
C D Lawhorn1, C M Bower, R E Brown
1Division of Pediatric Anesthesia, Arkansas Children's Hospital, Little Rock 72202-3591, USA.
Insights
Topical 4% lidocaine drops significantly improved pain relief after pediatric myringotomy tube placement. This reduces the need for additional pain medication, easing recovery for children and families.
Area of Science:
- Pediatric Otolaryngology
- Pain Management
- Anesthesiology
Background:
- Myringotomy with tube placement is a common pediatric surgery.
- Effective postoperative analgesia is challenging, often leading to patient distress.
Purpose of the Study:
- To evaluate the efficacy of topical 4% lidocaine in improving postoperative pain relief following myringotomy and tube insertion.
- To assess the impact on the need for supplemental analgesics.
Main Methods:
- A prospective, randomized, double-blind clinical trial was conducted.
- 122 pediatric patients (ASA class I or II) received either 4% lidocaine with antibiotic drops or placebo with antibiotic drops.
- Pain scores and acetaminophen use were primary outcome measures.
Main Results:
- Patients receiving 4% lidocaine showed significantly lower pain scores (2.81) compared to placebo (4.77) (P = 0.002).
- Lidocaine group had reduced need for acetaminophen (13%) versus the control group (45%) (P < 0.001).
- No adverse effects like vertigo or tinnitus were reported.
Conclusions:
- Topical 4% lidocaine combined with antibiotic drops is effective in enhancing postoperative analgesia after pediatric myringotomy and tube placement.
- This intervention can decrease pain and stress in the early postoperative period.
- It offers a safe and effective method to improve patient comfort and family experience.
Abstract:
One of the most frequently performed surgical procedures in pediatrics is myringotomy and tube placement. Analgesia is often difficult to achieve and children may be uncontrollable, distressing both parents and nursing staff. We designed this investigation to determine if topical lidocaine instilled in the ear canal after myringotomy and tube placement could improve postoperative analgesia. This prospective, randomized, double-blind clinical trial compared topical 4% lidocaine combined with antibiotic drops to placebo and antibiotic drops placed in the external auditory canal following completion of myringotomy and tube placement. One hundred twenty-two ASA class I or II patients were enrolled and completed this investigation. Primary outcome measure was relief of pain based on pain scores and the need for acetaminophen. Patients who received 4% lidocaine with gentamicin had better pain scores (2.81; P = 0.002) than those receiving placebo (4.77). Twenty-seven patients (45%) in the control group received acetaminophen for treatment of postoperative pain compared to eight (13%) in the lidocaine group (P < 0.001). No reports or complaints of vertigo or tinnitus were noted in any patient. The application of 4% lidocaine in antibiotic drops significantly improves postoperative analgesia in patients undergoing myringotomy and tube insertion under general anesthesia. Utilizing this technique should help improve analgesia, specifically in the early postoperative period, and decrease the presence of stress following surgery.