Rapid Analgesia With Lidocaine In Otalgia

Yıl 2017, Cilt: 9 Sayı: 6, 8 - 12, 17.11.2017

Prof. Dr. Erdinç Aydın

Öz

Abstract

Otalgia, or the pain localized to the ear is a common symptom encountered in the emergency departments, pediatric and otorhinolaryngology clinics. An effective treatment requires not only the best therapeutic approaches for the specific etiology, but also the control of pain. For the pain management, oral and local therapies can be used. Recently, local therapies have been frequently preferred, however the clinicians should meticulously be concerned about the patient selection, appropriate dosages, duration of activity and adverse effects, and also the presence of perforation in the tympanic membrane when using these medications. The objective of this review article, was to discuss Lidocaine (an amid group local anesthetic), which is the most commonly used local anesthetic drug, regarding the therapeutic effects on otalgia and its convenience.

Anahtar Kelimeler

Otalgia, local anesthetic drug, lidocaine

Otaljide Lokal Lidokain İle Hızlı Analjezi

Öz

Öz

Otalji, ya da kulağa lokalize ağrı acil servislerde. Pediatri ve otorinolaringoloji kliniklerinde sık rastlanılan bir semptomdur. Kulak ağrısı yaşanılan durumlarda tedavinin etkin olabilmesi, etiyolojiye yönelik tedavilerin yanı sıra, etkili ağrı kontrolünü sağlamakla mümkün olmaktadır. Ağrı için oral veya lokal tedaviler kullanılmaktadır. Son zamanlarda lokal anestezikler sıklıkla tercih edilmektedir. Ancak hasta seçimi, doz ayarlanması, etkinlik süresi ve yan etkiler, kulak zarında perforasyon olup olmaması konusunda hekimlerin bilinçli ve dikkatli olması önemlidir. Bu derleme ile en sık kullanılan lokal anesteziklerden biri olan Lidokainin (amid grubu lokal anestezik) otaljideki etkinliği ve güvenilirliği tartışılacaktır.

Anahtar Kelimeler

Otalji, lokal anestezik ilaçlar, lidokain

Kaynakça

• Kaynaklar 1.Harrison E, Cronin M. Otalgia. Aust Fam Physician 2016; 45(7): 493-97. 2.Cummings C. Cummings Otolaryngology Head & Neck Sur-gery. Philadelphia: Elsevier Mosby, 2005. 3.Weissman JL. A pain in the ear: the radiology of otalgia. AJNRAm J Neuroradiol 1997; 18 (9): 1641-51. 4.Levine HL. Otorhinolaryngologic causes of headache. MedClin North Am 1991; 75 (3): 677-92. 5.Yanagisawa K, Kveton JF. Referred otalgia. Am J Otolaryn-gol 1992; 13 (6): 323-37. 6.Majumdar S, Wu K, Bateman ND, Ray J. Diagnosis and management of otalgia in children. Arch Dis Child Educ PractEd 2009; 94 (2): 33-36. 7.Yeung P, Bridger A, Smee R, Baldwin M, Bridger GP. Malig-nancies of the external auditory canal and temporal bone: areview. ANZ J Surg 2002; 72 (2): 114-20. 8.Huang W, Vidimos A. Topical anesthetics in dermatology. J AmAcad Dermatol 2000; 43 (2 Pt 1): 286-98. 9.Mackie BS, Mackie LE. The PABA story. Australas J Derma-tol 1999; 40 (1): 51-53. 10.Fisher MM, Pennington JC. Allergy to local anaesthesia. BrJ Anaesth 1982; 54 (8): 893-94. 11.Covino BG. Pharmacology of local anaesthetic agents. Br JAnaesth 1986 Jul;58(7):701-16. 12.Taylor JA, Jacobs J. Homeopathic ear drops as an adjunct tostandard therapy in children with acute otitis media. Homeo-pathy 2011; 100 (3): 109-15. 13.Woodwell DA, Cherry DK National Ambulatory Medical CareSurvey: 2002 summary. Adv Data 2004; 346: 1-44. 14.Finkelstein JA, Davis RL, Dowell SF, et al. Reducing antibio-tic use in children: a randomized trial in 12 practices. Pedi-atrics 2001; 108 (1): 1-7. 15.Hayden GF, Schwartz RH. Characteristics of earache amongchildren with acute otitis media. Am J Dis Child 1985; 139 (7):721-23. 16.American Academy of Pediatrics Subcommittee on Manage-ment of Acute Otitis Media. Diagnosis and management of acu-te otitis media. Pediatrics 2004; 113 (5): 1451-65. 17.Sarrell EM, Cohen HA, Kahan E. Naturopathic treatment forear pain in children. Pediatrics 2003; 111 (5 Pt 1): e574-79. 18.Hannley MT, Denneny JC 3rd, Holzer SS. Use of ototopicalantibiotics in treating 3 common ear diseases. OtolaryngolHead Neck Surg 2000; 122 (6): 934-40. 19.Bolt P, Barnett P, Babl FE, Sharwood LN. Topical lignocai-ne for pain relief in acute otitis media: results of a double-blindplacebo-controlled randomised trial. Arch Dis Child 2008; 93(1): 40-44. 20.Foxlee R, Johansson A, Wejfalk J, Dawkins J, Dooley L, DelMar C. Topical analgesia for acute otitis media. Cochrane Da-tabase Syst Rev 2006; (3): CD005657. 21.Hoberman A, Paradise JL, Reynolds EA, Urkin J. Efficacy ofAuralgan for treating ear pain in children with acute otitis me-dia. Arch Pediatr Adolesc Med 1997; 151 (7): 675-78. 22.Bhananker SM1, Azavedo L, MacCormick J, Splinter W. To-pical lidocaine and oral acetaminophen provide similaranalgesia for myringotomy and tube placement in children.Can J Anaesth 2006; 53 (11): 1111-16. 23.Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical prac-tice guideline: acute otitis externa. Otolaryngol Head NeckSurg 2014; 150 (1 Suppl): S1-S24. 24.Pappas S, Nikolopoulos TP, Korres S, Papacharalampous G,Tzangarulakis A, Ferekidis E. Topical antibiotic ear drops: arethey safe? Int J Clin Pract 2006; 60 (9): 1115-19. 25.Höft J. The permeability of the round window membrane andits changes by pantocaine (tetracaine). Arch Klin Exp OhrenNasen Kehlkopfheilkd 1969; 193 (2): 128-37. 26.Osguthorpe JD, Nielsen DR. Otitis externa: Review and cli-nical update. Am Fam Physician 2006; 74 (9): 1510-16. 27.Beers SL, Abramo TJ. Otitis externa review. Pediatr EmergCare 2004; 20 (4): 250-56. 28.Myer CM 3rd. The evolution of ototopical therapy: from cu-min to quinolones. Ear Nose Throat J 2004; 83 (1 Suppl): 9-11. 29.van Balen FA, Smit WM, Zuithoff NP, Verheij TJ. Clinical ef-ficacy of three common treatments in acute otitis externa inprimary care: randomised controlled trial. BMJ 2003; 327(7425): 1201-5. 30.Goycoolea MV. Clinical aspects of round window membranepermeability under normal and pathological conditions.Acta Otolaryngol 2001; 121 (4): 437-47. 31.Goycoolea MV, Lundman L. Round window membrane.Structure function and permeability: a review. Microsc Res Tech1997; 36 (3): 201-11. 32.Goycoolea MV, Muchow DC, Schirber CM, Goycoolea HG,Schellhas K. Anatomical perspective, approach, and experi-ence with multichannel intracochlear implantation. Laryngos-cope 1990; 100 (2 Pt 2 Suppl 50): 1-18. 33.Carpenter AM, Muchow D, Goycoolea MV. Ultrastructural stu-dies of the human round window membrane. Arch Otolaryn-gol Head Neck Surg 1989; 115 (5): 585-90. 34.Rahm WE Jr, Strother WF, Crump JF, Parker DE. The effectsof anesthetics upon the ear. IV. Lidocaine hydrochloride. AnnOtol Rhinol Laryngol 1962; 71: 116-23. 35.Goycoolea MV, Muchow D, Schachern P. Experimental stu-dies on round window structure: function and permeability.Laryngoscope 1988; 98 (6 Pt 2 Suppl 44): 1-20. 36.Engberg G, Danielson K, Henneberg S, Nilsson A. Plasma con-centrations of prilocaine and lidocaine and methaemoglobinformation in infants after epicutaneous application of a 5%lidocaine-prilocaine (EMLA). Acta Anaesthesiol Scand 1987;31 (7): 624-28. 37.de Waard-van der Spek FB, Oranje AP, Lillieborg S, Hop WC,Stolz E. Treatment of molluscum contagiosum using a lidocai-ne/prilocaine cream (EMLA) for analgesia. J Am Acad Der-matol 1990; 23 (4 Pt 1): 685-88. 38.Raso SM, Fernandez JB, Beobide EA, Landaluce AF. Methe-moglobinemia and CNS toxicity after topical application ofEMLA to a 4-year-old girl with molluscum contagiosum. Pe-diatr Dermatol 2006; 23 (6): 592-93. 39.Nicholas E, Thornton MD. Lidocaine Toxicity During Attemp-ted Epistaxis Cautery. J Emerg Med 2016; 51 (3): 303-304. 40.Verma M, Aggarwal A. Glucose--6 phosphate dehydrogena-se deficiency with methemoglobinemia. Indian Pediatr 1977;14 (10): 831-36. 41.Vessely MB, Zitsch RP 3rd. Topical anesthetic-induced met-hemoglobinemia: a case report and review of the literature.Otolaryngol Head Neck Surg 1993; 108 (6): 763-67. 42.Weinberg GL. Lipid infusion therapy: translation to clinicalpractice. Anesth Analg 2008; 106 (5): 1340-42. 43.Larson A, Stidham T, Banerji S, Kaufman J. Seizures and met-hemoglobinemia in an infant after excessive EMLA applica-tion. Pediatr Emerg Care 2013; 29 (3): 377-79. 44.François M. Efficacy and tolerance of a local application ofphenazone and chlorhydrate lidocaine (Otipax) in infants andchildren with congestive otitis. Ann Pediatr (Paris) 1993; 40(7): 481-84.