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№4(6) 2023

Укр

DOI 10.37219/2528-8253-2023-4-77

Popovych VI, Koshel IV, Malofiichuk OM, Piletska LI, Kapustina NM

A RETROSPECTIVE COMPARISON OF THE EFFICACY OF PAIN MANAGEMENT WITH A LOCAL APPLICATION OF PHENAZONE AND LIDOCAINE AND SYSTEMIC IBUPROFEN IN TREATMENT OF ACUTE OTITIS MEDIA IN CHILDREN

Popovych Vasyl I.
Lviv Medical University
Head of the Department of Surgery №1
Doctor of Medical Sciences, Professor
E-mail: popovychvasyl@gmail.com
ORCID ID: https://orcid.org/0000-0002-2898-8474

Koshel Ivanna V.
Ivano-Frankivsk National Medical University
Head of the Department of Otolaryngology with a course in head and neck surgery
Doctor of Medical Sciences, Professor
Email: ivannakoshel@gmail.com
ORCID ID: https://orcid.org/0000-0002-5466-4537
Scopus Author ID: 57218684995

Malafiichuk Oleksandr M
Zhytomyr Regional Clinical Hospital
Head of the Department of Otolaryngology
Email: zht.lor@gmail.com
ORCID ID: https://orcid.org/0009-0005-1539-1846

Piletska Lyubov I
Ivano-Frankivsk Regional Children’s Clinical Hospital
Department of otorhinolaryngology
Resident physician
Email: Lor.piletcka@ukr.net
ORCID ID: https://orcid.org/0009-0008-6091-8178

Kapustina Natalia M
Zhytomyr Regional Clinical Hospital
Department of Otolaryngology
Otolaryngologist
Email: zht.lor@gmail.com
ORCID ID: https://orcid.org/0000-0002-1073-5719

Abstract

Ear pain is the most common symptom of acute otitis media (AOM); thus, according to current guidelines, the main goal of treatment should be to relieve ear pain. A drawback of systemic painkillers is their slow onset of action and a high frequency of side effects. The use of local anesthetic agents holds promising potential for correcting pain syndrome.

Aim: to comparatively evaluate the efficacy of a local application of phenazone in combination with lidocaine and systemic pain management with ibuprofen as components of analgesic drug therapy in children with AOM.

Methods: A retrospective analysis included 61 patients who received Otipax ear drops containing phenazone and lidocaine (the main group) or ibuprofen (the control group).

Evaluation criteria: reduction in the severity of disease symptoms on a 10-point visual analogue scale during the 10-day observation period in comparison to the first visit, the need for additional pain relief therapy, and the number of side effects.

Results: The topical application of the anti-inflammatory agent phenazone in combination with the anesthetic lidocaine demonstrates a significant analgesic effect. The frequency of using additional pain relief during systemic or topical correction of ear pain syndrome shows no significant differences (p>0.05). Compared to topical application of phenazone in combination with lidocaine, the analgesic effect of systemic ibuprofen is accompanied by a significantly higher number of side effects (p<0.05).

Conclusion: In patients with AOM, pain management using the topical combination of phenazone and lidocaine provides a pronounced clinical effect and the need for additional pain relief during topical correction of ear pain syndrome shows no significant differences compared to systemic ibuprofen (p>0.05). Systemic ibuprofen for pain relief is associated with a significantly higher occurrence of undesired adverse effects compared to the topical combination of phenazone and lidocaine (p<0.05). The inclusion of analgetic monotherapy, specifically phenazone in combination with lidocaine, in the treatment regimen for patients with AOM is reasonable as a component of an adequate pain management strategy.

Keywords: acute otitis, respiratory infections, children, pain management

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