In outpatient clinics, local pain control is an advantage to general anesthesia, and this is the case for myringotomy as well. The solid anesthetics are usually tetracaine, cocaine, or dibucaine hydrochloride (Nupercain), and the free bases are stronger than their hydrochlorides of the same concentration. However, in topical anesthesia for myringotomy, the main problem is the penetration1 of the drum, and the choice of solvent is important. Dimethylsulfoxide or DMSO, which looked promising,2 is now removed from medical use in the United States and the glycolethers are a possible substitute. The glycols are alcohols with two–OH groups; when one–OH is converted into an ether, we obtain an ether-alcohol, which is miscible with both water and oils. Introduction of butyl C4H9-CH3-CH2-CH2-CH2 produces monobutylethers, which cause numbness of the lips and will increase the effect of the
Guldberg OF. A New Anesthetic for Myringotomy. Arch Otolaryngol Head Neck Surg. 1993;119(12):1384. doi:10.1001/archotol.1993.01880240124022
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