In children with acute otitis media, topical 1% lidocaine ear drops with ibuprofen or paracetamol may offer rapid and effective relief in ear pain.

A multicenter randomized, open-label study was conducted to compare the efficacy of oral analgesics alone vs. topical 1% lidocaine ear drops + oral analgesics for the management of acute otitis media.

Overall, 184 pediatrics (1 to 5 years of age) suffering from acute otitis media and bilateral ear pain were recruited. All the patients were randomly administered paracetamol or ibuprofen and topical 1% lidocaine to each ear. Overall, 22.3% of patients were given paracetamol,  24.5% were administered paracetamol with lidocaine ear drops, 23.4% were given ibuprofen, and 29.9% were administered ibuprofen with lidocaine ear drops. Within forty-eight hours, an evaluation of ear pain score was done utilizing Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Participants were monitored for ten days.

Reduction in pain scores in the paracetamol and lidocaine vs. paracetamol groups and the ibuprofen and lidocaine vs. ibuprofen groups at baseline and ten minutes was found to be 25% and 50% respectively. There were no adverse events reported.

For children presenting with ear pain attributed to acute otitis media, topical anesthetic ear drops along with systemic oral analgesics are accessible and beneficial agents for relieving ear pain.