Two studies were performed to determine whether topical phenol is a safe and well tolerated local anaesthetic for grommet insertion. Study 1 was a retrospective examination of audiological outcomes and complications. Data were obtained regarding 71 procedures in 57 patients. One late infection and nine early extrusions were noted. No statistically significant changes between pre- and post-operative bone conduction thresholds were found. Study 2 was a prospective analysis of patients' perceptions of the procedure. Data from 17 patient questionnaires were analysed as follows: pain rating – not painful, three patients; slightly painful, 14 patients. Overall experience rating – pleasant, four patients; slightly unpleasant, 10; unpleasant, three. All patients stated that they would undergo the procedure again. In conclusion, we found no evidence of phenol-induced hearing loss. The complication rate was within normal limits and patients were satisfied with the procedure. Grommet insertion using phenol as a local anaesthetic is safe and acceptable to patients.

Sixty children undergoing inguinal or urogenital surgery were allocated randomly to three groups to receive a caudal injection of either 0.125% bupivacaine 0.75 mL kg−1 with 0.5% midazolam 50 μg kg−1 (n=20) or with 1% morphine chlorhydrate 0.05mg kg−1 (n=20), or bupivacaine alone (n=20) after surgery under general anaesthesia. There were no significant changes in heart rate, blood pressure, respiratory rate or oxygen haemoglobin saturation values in all groups, and there were no significant differences in the incidence of vomiting and pruritus between the groups (P>0.05). Sedation scores were higher in the bupivacaine-midazolam and the bupivacaine-morphine groups than in the bupivacaine group at 8–12 h post-operatively (P<0.01). The durations of analgesia were 21.15±1.2 h in the bupivacaine-midazolam group, 14.50±1.6 h in the bupivacaine-morphine group and 8.15±1.3 h in the bupivacaine group. Differences between the bupivacaine-midazolam group and the bupivacaine group (P<0.001), the bupivacaine-midazolam group and the bupivacaine-morphine group (P<0.01), and the bupivacaine-morphine group and the bupivacaine group (P<0.01) were significant. It is suggested that caudal administration of a bupivacaine-midazolam mixture produces a longer duration of post-operative analgesia than a bupivacaine-morphine mixture and bupivacaine alone with sedation for 8–12 h post-operatively.