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Editor,—We wish to congratulate the authors on the much overdue review of techniques for removal of foreign bodies from the ear and nose.1 We read the review with interest.
Dr Davies1 and Mr Kalan2 have described application of local anaesthetic to the nasal passage by spraying it with 4% lignocaine (lidocaine) solution. Our experience shows that this method is very effective but makes the already apprehensive child more frightful. We wish to share our experience of application of 4% lignocaine (lidocaine) by a more pleasant method.
After confirming the presence and the nature of the foreign body we educate the parent on the following.
The anaesthetic liquid at the end of the cotton bud (Q-tip) should be allowed to run off the bud into the nasal passage and the bud should not be inserted into nose.
We spray a good size drop of standard 4% lignocaine (lidocaine) solution on to the end of a cotton bud (Q-tip). Then with the child lying down we let the parent install the same into the side of the appropriate external nare under direct medical supervision. This effectively anaesthetises the nasal passage and aids removal. This method of local anaesthetic application does not upset either the child or the parent.
This successful method of effective application of local anaesthetic was acceptable to the child and appreciated by the parents.