Topical anesthetics (Lidocaine)
Lidocaine is one of the commonly used topical anesthetics used in pain
management in patients with oral mucositis. Paraquat induced oral
mucositis is characterized by pain. The presence of persistent pain not
only affects the patients psychologically but also decreases their
incentive and the ability for oral intake. Therefore, pain control
eventually encourages oral intake, thus improving nutrition and reducing
further complications. The different formulations of lidocaine (sprays,
solutions, gels and ointments) provide clinicians with options to choose
for the most effective formulation for maximal effect; Solutions are
effective when anesthetics are needed to cover a wide surface area
without the risk of aspiration. Four studies showed the benefit of
lidocaine in reduction of pain and severity of oral mucositis.19 20 2124 The first two studies compared lidocaine gargle as
compared to bland rinses and symptomatic management, the incidence of
oral mucositis and pain decreased in both trials by 23.33% and 40%
respectively. 19 20. The other two
studies in-cooperated lidocaine as one of the ingredients for a
compounded preparation, both studies reported adequate pain management.21 24 The main adverse effects
associated with lidocaine are burning and stinging on the local site of
administration, loss of taste due to anesthetization of the taste buds,
and suppression of gag-reflex if the posterior oropharyngeal area is
anesthetized26