A Clinical Study to Evaluate the Efficacy of 10% Topical Lidocaine as Compared with EMLA Cream for Minor Otologic Surgery

Chang, Hyung Wook

Abstract

BACKGROUND AND OBJECTIVES
Minor otologic surgeries, such as tympanic injection, myringotomy and ventilating tube insertion are a common otologic procedure. Effective, safe and comfortable anesthetic method is very useful alternative to lidocaine infiltration anesthesia. This study was designed to assess the efficacy of topical lidocaine as compared with eutectic mixture of local anesthetics (EMLA) for pain relief during minor otologic surgery. MATERIALS AND METHODS: One hundred eight patients who were between the age of 4 and 71 years were allocated randomly into 4 groups. Group I (n=30) received 1 spary of topical lidocaine: group II (n=34), 2 sprays of topical lidocaine: group III (n=23), 1 cc of EMLA cream: and group IV (n=21), 2 cc of EMLA cream to the ear canal. Groups were randomized to perform one of otologic minor surgery at anesthetic application time of either 10 or 20 minutes respectively. Patients rated pain and satisfaction during surgery on the comfort scale score. RESULTS: All surgeries were successfully without additional anesthesia. At 10 minute application, group I and II showed significantly lower comfort scores of pain compared with group III (p<0.05). Group II showed significantly lower scores than group III at 20 minute application (p<0.05). In lidocaine applied group I and II comfort scores of pain were significantly lower at 20 minute application than 10 minute application (p<0.05). There was one complication of severe vertigo after one hour of procedure in group II. CONCLUSION: This study demonstrates that 10 minute application of topical lidocaine is more effective for relieving pain associated with minor otologic surgery in office than 10 minute application of EMLA cream and 20 minute application of lidocaine is more effective than 10 minute application.