Is Lidocaine Infiltration Really Necessary in Micro Ear Surgeries performed Under General Anaesthesia?

Abstract

To study the role of infiltrating 2% Lidocaine in Micro ear surgeries performed under general anaesthesia. To measure the impact of infiltration of 2% Lidocaine in post operative pain relief and per operative bleeding. A Double blinded, Prospective randomized comparative study was conducted in a tertiary care referral centre. A total of 30 patients planned for micro ear surgeries under general anaesthesia (Tympanoplasty and Cortical mastoidectomy) for CSOM tubotympanic disease were selected and divided into two groups randomly by the chief senior consultant. Group A patients received local infiltration of 2% Lidocaine with one in 200,000 adrenaline and Group B patients received infiltration of one in 200,000 adrenaline in distilled water alone. Operating surgeon assessed the bleeding in the surgical field using Boezaart's grading system. Post operative pain was assessed using a visual analog scale. Pain scores of these patients were assessed in the 1st, 4 and 24th h post operatively and recorded. The mean post operative pain score in the 1st h for the patients in Group A was 0.93 and for patients in Group B was two. The difference in the pain scores between the two groups was significant (P \ 0.02).The difference in the mean post operative pain scores between the two groups in the 4 and 24th h were not significant (P \ 0.1).Per operatively, grade III bleeding was present in 73% of patients in group B and only 33% of patients had grade III bleeding in group A. Infiltration of 2% Lidocaine has a significant impact over the grade of bleeding in the operative field and also on 1st h post operative pain relief. It did not have a significant influence on the pain relief in the 4 and 24th h post operatively.

A Historical Review of Indian Perspectives on Techniques of Tympanoplasty

“…Senthil et al in 2012 in a prospective comparative study reported that infiltration of 2% lidocaine with 1 : 200,000 adrenaline has a significant effect over the grade of bleeding in the operative field and also on first one-hour postoperative pain relief. ey used Boezaart's grading system for recording preoperative bleeding and visual analogue scale for postoperative pain in patients having chronic otitis media, who were randomly allocated in two groups [27].…”

Comparative Study of Infiltration of Lidocaine with Adrenaline versus Sterile Water in Type 1 Tympanoplasty Performed under General Anaesthesia

“…But it does not have any influence over 4th and 24th hour post-operative pain score. 6 In our study we found that, infiltration of 2% lignocaine with 1:2,00,000 adrenaline has a significant impact over 2nd post-operative hour pain score, but no impact with total amount of blood loss and 4th and 6th post-operative hour pain score.…”