A comparison of topical Emla cream with Bonain's solution for anesthesia of the tympanic membrane during tympanocentesis.

The purpose of this study was to investigate the relative efficacy of Emla cream (a eutectic formulation of lignocaine and prilocaine) and Bonain's solution (equal amounts of cocaine hydrochloride, menthol and phenol) as local anesthetic agents to the tympanic membrane. Fifty patients undergoing bilateral tympanocentesis were included. The patients were used as their own controls. One tympanic membrane was anesthetized with Emla cream and the other with Bonain's solution. The operating microscope was used. After a 30 min analgesic time, tympanocentesis was performed with aspiration of middle ear secretions. Each patient was then asked to fill in a questionnaire that graded the severity of pain experienced: none, very mild, mild, moderate or severe. Findings showed that Bonain's solution was more effective in tympanocentesis. All patients experienced no pain to very mild pain. With Emla cream 15 of 50 patients experienced mild to moderate pain. No significant side effects occurred with either anesthetic agent.