From the Research
For a patient with severe throat pain from vomiting due to viral gastroenteritis, lidocaine gargle should be administered 15-30 minutes before meals and as needed for pain relief. A typical regimen is 2% viscous lidocaine, using 5-10 mL diluted with an equal amount of water, gargled for 30-60 seconds and then spit out (not swallowed). The gargle can be used every 3-4 hours as needed, not exceeding 8 doses in 24 hours. Timing it before meals is optimal because it allows the patient to eat more comfortably when the anesthetic effect is at its peak, potentially improving nutrition and hydration during illness. Additionally, using the gargle after vomiting episodes can provide immediate relief to irritated throat tissues. Patients should be cautioned not to eat or drink for 30-60 minutes after gargling to prevent choking, as the numbing effect reduces the gag reflex and swallowing sensation. For children or elderly patients, a lower concentration or smaller volume may be appropriate to reduce systemic absorption risks. The most recent study on viral gastroenteritis 1 does not provide specific guidance on the use of lidocaine gargle, but the general principles of pain management in gastroenteritis are relevant. However, the study on clinical practice guideline for sore throat 2 provides some relevant information on the management of sore throat, which can be applied to this patient's condition. It is also important to note that the patient's condition is caused by viral gastroenteritis, and the use of antibiotics is not recommended unless there is a clear indication of bacterial infection 2, 3. The study on the association between acute gastroenteritis and continuous use of proton pump inhibitors 4 is not directly relevant to this patient's condition, but it highlights the importance of considering the potential risks and benefits of different treatments. Overall, the use of lidocaine gargle for throat pain in a patient with viral gastroenteritis should be guided by the principles of pain management and the potential risks and benefits of different treatments. Key points to consider include:
- Administering lidocaine gargle 15-30 minutes before meals and as needed for pain relief
- Using a typical regimen of 2% viscous lidocaine, 5-10 mL diluted with water, gargled for 30-60 seconds and then spit out
- Cautioning patients not to eat or drink for 30-60 minutes after gargling to prevent choking
- Considering a lower concentration or smaller volume for children or elderly patients to reduce systemic absorption risks.