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August 1969

Tetracaine Base: An Effective Surface Anesthetic for the Tympanic Membrane

Author Affiliations

USA; USA, San Francisco
From the USA Tripler General Hospital, APO San Francisco. Dr. Silverstein is now with the Massachusetts Eye and Ear Infirmary, Boston, Mass, and Dr. Call is currently in Phoenix, Ariz.

Arch Otolaryngol. 1969;90(2):150-151. doi:10.1001/archotol.1969.00770030152010

THERE have been numerous solutions advocated since 1884 to anesthetize the tympanic membrane. Uhde1 has written an excellent review of the subject. He was the first (in 1957) to report that tetracaine salt, when converted into the base form, had increased anesthetic properties when applied to the tympanic membrane. Abramson2 found that tetracaine base powder, when dissolved in alcohol and applied to the tympanic membrane for one hour, acted as an effective surface anesthetic. We have found that by increasing the concentration of the tetracaine base alcohol solution anesthesia of the tympanic membrane can be achieved in less time. Also, by supplementing the local anesthesia with intramuscularly administered meperidine (1 mg/lb), pressure equalizing tubes may be inserted into the tympanic membrane as a painless office procedure.

The method is as follows. Dry tetracaine (Pontocaine) base, a powder, is purchased in bulk quantities. The powder is divided into 80

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