The impact of different local anesthetic methods on pain scores for intratympanic injections

Objectives: This study compared the effectiveness of different preparations in reducing pain. Patients and Methods: The double-blind study was conducted between October 2023 and March 2024. Four different premedications (phenazone, lidocaine, Xylocaine, and physiological saline) were administered to patients to reduce pain. Twenty minutes after each procedure, the patient's pain levels were assessed using the Visual Analog Scale and Categorical Rating Scale-4. Patients were asked to select their preferred method of intratympanic injection at the end of all procedures. Results: One patient was excluded due to a perforated eardrum. Thirty-eight patients (24 females, 14 males; mean age: 53.1±13.6 years; range, 27 to 76 years) were included in the study. The intratympanic injection of Xylocaine and physiological saline resulted in significantly less pain than lidocaine. Fifteen (39.5%) patients favored Xylocaine, while 14 (36.8%) patients chose physiological saline. Conclusion: Xylocaine and physiological saline were more effective premedications than lidocaine and phenazone. Xylocaine, due to its deionized structure, was superior to lidocaine but did not provide greater efficacy compared to physiological saline. Further studies are needed to develop new agents, particularly deionized drops.