| The Analgesic Efficacy of a 5% Eutectic Mixture of Lidocaine and Prilocaine Prior to Insertion of Spinal and Epidural Block. |
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Yeon Jae Kim, Mi Hwa Jung, Young Ryong Choi, Hue Jung Park, Rim Soo Won, Jin Young Lee, Jin Kyung Jung |
1Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Seoul, Korea. leejy7035@yahoo.co.kr
2Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. |
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| 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. |
| Key Words:
epidural anesthesia; eutectic mixture of lidocaine and prilocaine; infiltration; lidocaine; spinal anesthesia |
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