The Analgesic Efficacy of a 5% Eutectic Mixture of Lidocaine and Prilocaine Prior to Insertion of Spinal and Epidural Block.
10.4097/kjae.2008.54.4.395
- Author:
Yeon Jae KIM
1
;
Mi Hwa JUNG
;
Young Ryong CHOI
;
Hue Jung PARK
;
Rim Soo WON
;
Jin Young LEE
;
Jin Kyung JUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Seoul, Korea. leejy7035@yahoo.co.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
epidural anesthesia;
eutectic mixture of lidocaine and prilocaine;
infiltration;
lidocaine;
spinal anesthesia
- MeSH:
Adult;
Analgesia;
Anesthesia, Epidural;
Anesthesia, Spinal;
Benzeneacetamides;
Humans;
Lidocaine;
Lower Extremity;
Needles;
Piperidones;
Prilocaine;
Punctures;
Skin
- From:Korean Journal of Anesthesiology
2008;54(4):395-399
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We evaluated the analgesic efficacy of a 5% eutectic mixture of lidocaine and prilocaine (EMLA(R)) topically applied before performing skin puncture for spinal or epidural anesthesia. METHODS: The patient population consisted of 75 ASA physical status 1 and 2 adults scheduled for operations of the lower abdominal region, the perineal region or the lower extremities. The patients were randomly allocated to one of five groups of equal size: group A - topical application of EMLA(R) cream 120 min before spinal block; group B - subcutaneous infiltrationof 2 ml of 2% lidocaine immediately before spinal block; group C - no pretreatment before spinal block; group D - topical application of EMLA(R) cream 120 min before epidural block; and group E - subcutaneous infiltration of 2 ml of 2% lidocaine immediatelybefore epidural block. Pain experienced during the whole procedure was rated using a 10 cm visual analogue scale. RESULTS: Patients in group A experienced less pain compared with those in groups B and C (2.0 +/- 1.9 cm vs 4.1 +/- 1.9 cm and 3.9 +/- 2.2 cm, respectively; P < 0.05). However there was no significant difference between group D and group E (3.6 +/- 2.4 cm vs 4.1 +/- 2.5 cm). The patients in group A and group D were highly satisfied with the method of analgesia (P < 0.05). CONCLUSIONS: EMLA(R) cream is an effective alternative to subcutaneous infiltration of local anesthetic for analgesia during skin puncture using a 25 G spinal needle. It provides insufficient analgesia however for epidural anesthesia.
