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A double blind, randomised placebo controlled trial of topical 2% viscous lidocaine in improving oral intake in children with painful infectious mouth conditions

DOI: 10.1186/1471-2431-11-106

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Abstract:

This study is a randomised double-blind placebo controlled trial of children between 6 months and 8 years of age with painful infectious mouth conditions defined as gingivostomatitis (herpetic or non herpetic), ulcerative pharyngitis, herpangina and hand foot and mouth disease as assessed by the treating clinician in association with a history of poor oral fluid intake. It will be conducted at a single tertiary paediatric emergency department in Melbourne Australia.20 patients have already been randomised to receive 2% lidocaine or placebo in a pilot study to determine the sample size in a preplanned adaptive design. A further 80 patients will be randomised to receive either 2% lidocaine or placebo. The placebo agent is identical to lidocaine in terms of appearance, flavour and smell. All clinical and research staff involved, patients and their parents will be blinded to treatment allocation.The primary endpoint is the amount of fluid ingested by each child, expressed in ml/kg, within 60 minutes from the time of administration of the study mixture. Secondary endpoints are the proportion of patients ingesting 5 ml/kg and 10 ml/kg at 30 and 60 minutes after drug administration and the incidence of adverse events. Longer term outcomes will include the proportion of patients requiring hospital admission and length of emergency department stay.This trial will define the role of 2% lidocaine in the treatment of painful infectious mouth conditionsThe trial is registered with the Australian and New Zealand Clinical Trials Registry - ACTRN12609000566235.Painful infectious mouth conditions are a common presentation to paediatric emergency departments. These are usually viral conditions such as gingivostomatitis (herpetic and non herpetic), ulcerative pharyngitis, herpangina and hand foot and mouth disease. Most of the paediatric literature concerns primary herpetic gingivostomatitis (PHGS) caused by infection with the herpes simplex virus. Although self limiting, there is con

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