Inclusion criteria - all of: |
Diagnosed by the treating doctor with ulcerative pharyngitis, herpangina, hand foot and mouth disease, herpetic gingivostomatitis OR non-herpetic gingivostomatitis |
Parental complaint of child's poor oral intake |
Intake of less than 10 ml/kg of fluid within 2 hours preceding presentation to RCH ED |
Exclusion criteria - any of: |
Presence of more than 2 vomits within 24 hours preceding presentation to RCH ED |
Presence of active painful dental disease (caries, dental abscess) or painful recent mouth trauma, mouth burn, or post-operative state (minimum of 5 days) |
Systemic toxicity related to infection, as defined by the treating doctor |
Severe dehydration requiring immediate therapy, as defined by the treating doctor |
Known allergy to local anaesthetic, gelatine, methylcellulose, cherry flavouring, paracetamol or ibuprofen |
Chronic renal or liver impairment |
History of epilepsy or cardiac disease |
Presence of acute porphyria |
Presence of malignancy |
Current use of anti-arrhythmic drugs, xylocaine, phenytoin, cimetidine or beta-blockers, warfarin, lithium, angiotensin converting enzyme (ACE) inhibitors, thiazide diuretics, frusemide, aspirin, salicylates, probenecid, anti-diabetic medications, zidovudine, cardiac glycosides or methotrexate |
More than 1 dose of 2% viscous lignocaine or medications containing lignocaine as the active ingredient for this episode of illness |
Pre-existing upper airway obstruction and/or swallowing difficulties |
Analgesia taken within 1 hour preceding enrolment to study Non-English speaking parents/guardians |