理想的鼓膜局部麻醉法是所有耳鼻喉科醫師,尤其是開業同仁共同的期望。過去所使用的方法包括Bonain氏溶液、離子電泳法和局部麻醉劑注射,雖然都可以達到一定的麻醉效果,但是很難完全符合方便無痛、作用迅速、不傷害組織、以及充分的麻醉效果等要求。台北榮民總醫院自民國82年2月至82年9月間總共在46例病耳(45名病人)上以EMLA乳膠對鼓膜施予局部麻醉後,進行包括通氣置入取出、耳蝸電極針置入和鼓膜穿刺等門診小手術。結果有39例(85%)可達完全麻醉的程度,45例(98%)可以在不需要進一步麻醉的情況下順利完成手術。作者建議的麻醉時間是20至25分鐘,麻醉前應仔細清除鼓膜和外耳道的耳垢和異物,使用足夠的EMLA乳膠並與鼓膜緊密接觸,取出棉球後應將乳膠吸除乾淨。
An ideal topical anesthesia on the tympanic membrane has long been looked for. Bonain’s solution, iontophoresis and injection of anesthetic agents have been used widely; however, sometimes they cannot completely fulfil the expectation of rapid onset of anesthesia, easy and painless application. We applied EMLA on the tympanic membranes of forty six ears for tympanocentesis, ECoG needle insertion, grommet insertion and removal. Thirty nine ears (85%) had complete, painless anesthetic effect; while forty five ears (98%) could be operated upon without the need of adding other anesthesia.