A Cochrane review 1 included 5 studies with a total of 391 children aged 3 to 18 years. 2 studies (n=117) compared anaesthetic ear drops versus placebo immediately at diagnosis. All children received some form of oral pain relief. There was a statistically significant difference in the proportion of children achieving a 50% reduction in pain in favour of anaesthetic drops 10 minutes after instillation (RR 2.13, 95% CI 1.19 to 3.80) and 30 minutes after instillation (RR 1.43, 95% CI 1.12 to 1.81) on the day acute otitis media (AOM) was diagnosed but not at 20 minutes (RR 1.24, 95% CI 0.88 to 1.74).
Three trials (with one common co-author) compared anaesthetic ear drops with naturopathic herbal ear drops in 274 patients. One of these trials also used antibiotics in both groups. Naturopathic drops were favoured 15 and 30 minutes after instillation, 1 to 3 days after diagnosis, but the differences were not statistically significant.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).
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