What are the names of commonly used anesthetic ear drops?

Commonly Used Anesthetic Ear Drops

Benzocaine and antipyrine combination (Auralgan) is the most commonly used anesthetic ear drop for ear pain relief, though it should be used cautiously and only for short periods as it may mask symptoms of delayed response to therapy. 1

Types of Anesthetic Ear Drops

FDA-Approved Anesthetic Ear Drops

• Benzocaine-based products:
  • Antipyrine and Benzocaine Otic Solution (Auralgan) - contains antipyrine 54 mg and benzocaine 14 mg per mL 1
  • Primary mechanism: Benzocaine provides local anesthetic effect while antipyrine offers analgesic properties

Other Anesthetic Ear Drop Options

• Lidocaine-based products:
  • Lidocaine with phenylephrine (Co-phenylcaine) spray - can be used with soaked micropatties for tympanic membrane and ear canal anesthesia 2

Usage Guidelines and Cautions

When to Use Anesthetic Ear Drops

• For temporary relief of ear pain associated with acute otitis externa (AOE) or acute otitis media (AOM)
• For pre-procedural anesthesia before ear canal procedures
• For removal of cerumen (ear wax) - can help detach cerumen from the wall of ear canal 1

Important Cautions

• The American Academy of Otolaryngology-Head and Neck Surgery recommends oral analgesics (acetaminophen or NSAIDs) for pain relief rather than anesthetic ear drops, as anesthetic drops can mask symptoms of delayed response to therapy 3
• Avoid using topical anesthetic drops for more than 48 hours without re-examination 3
• Do not use if tympanic membrane integrity is uncertain or if tympanostomy tubes are present 3

Administration of Ear Drops

Proper Application Technique

• Have patient lie down with affected ear facing up
• Fill ear canal with drops, allowing solution to run along the wall of the canal
• Avoid touching the ear with dropper
• Have patient remain in position for 3-5 minutes
• For enhanced effect, moisten a cotton pledget with the solution and insert into meatus 4, 1

Dosing

• For acute otitis media: Instill drops and repeat every 1-2 hours until pain and congestion are relieved 1
• For cerumen removal: Use three times daily for 2-3 days to help detach cerumen 1

Efficacy and Evidence

• Research shows that Auralgan (benzocaine-antipyrine) provides additional relief within 30 minutes when used alongside acetaminophen for children with AOM-associated ear pain 5
• A randomized controlled trial found that anaesthetic-analgesic ear drops may reduce antibiotic consumption in children with AOM 6

Alternative Pain Management Approaches

• For primary pain management, the American Academy of Otolaryngology-Head and Neck Surgery recommends:
  • Oral analgesics such as acetaminophen or NSAIDs with fixed interval dosing rather than as-needed for better pain control 3
  • Topical combination therapy with ciprofloxacin 0.3%/dexamethasone 0.1% otic suspension as first-line treatment for ear pain associated with acute otitis externa 3

Special Considerations

• Allergic contact dermatitis can occur with prolonged use of antimicrobial otic drops, particularly with neomycin-containing products (13-30% prevalence) 4
• Contact sensitivity may also result from topical anesthetics like benzocaine alone or combined with dibucaine and tetracaine 4
• Iontophoresis technique can be used for local anesthesia of the ear canal and tympanic membrane in outpatient settings 7

Remember that while anesthetic ear drops may provide temporary relief, they should be used judiciously and not as a substitute for appropriate treatment of the underlying condition.