A comparison of topical EMLA cream and Prilocaine injection for anaesthesia of the tympanic membrane in adults.

To date there is no ideal method of painlessly achieving anaesthesia of the ear drum for myringotomy and grommet insertion. In this double blind, placebo controlled prospective study we have assessed a new topical anaesthetic agent (EMLA Cream) for use on keratinised squamous epithelium. A comparison has been made with the anaesthesia achieved by an injected agent. Twenty individuals were randomly allocated to receive placebo or EMLA cream. Their relative discomfort was measured on a visual analogue scale. Ten individuals received injected anaesthetic prior to myringotomy and grommet insertion and the discomfort of injection and of the procedure were similarly measured. We found EMLA cream to be an equally effective method of anaesthetising the ear drum as an injected agent. In addition there was minimal discomfort in the achievement of this anaesthesia. The discomfort of injecting the ear canal is shown to be similar to that of performing myringotomy and grommet insertion without anaesthesia.