Lidocaine/prilocaine cream (EMLA(R)) versus infiltration anaesthesia: a comparison of the analgesic efficacy for punch biopsy and electrocoagulation of genital warts in men.
OBJECTIVE
To compare analgesic efficacy and pain caused by administration of lidocaine/prilocaine cream (EMLA(R)) versus xylocaine 1% local infiltration for punch biopsy and electrocoagulation of genital warts in men.


METHODS
Open randomised comparative parallel-group study.


METHODS
Department of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, the Netherlands.


METHODS
63 males with warts on the genital mucosa and/or perianal area.


METHODS
EMLA(R) cream (2.5-5 g) was applied during 13-45 minutes before surgery. Xylocaine 1% (0.1-4 ml) was infiltrated 0.5-4 minutes before surgery. Pain during administration and surgery was assessed by the patient on a verbal rating scale and on a visual analogue scale.


RESULTS
EMLA(R) application was painless in all patients (n = 31) whereas xylocaine infiltration was slightly painful in 17/29 patients and moderately painful in 10/29 patients. EMLA(R) analgesia was satisfactory for 94% of biopsies and 62% of electrocoagulations. Xylocaine infiltration was satisfactory in all procedures.


CONCLUSIONS
EMLA(R) application on the male genital mucosa is painless but it has a lower analgesic efficacy than xylocaine infiltration. However EMLA is a useful anaesthetic for taking biopsies in this area and may be used as premedication for local infiltration.
vd Berg
G M
GM
Department of Dermatovenereology, University Hospital Rotterdam/Dijkzigt, The Netherlands.
Lillieborg
S
S
Stolz
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local; D001706:Biopsy / Q000379:methods; D004338:Drug Combinations; D004564:Electrocoagulation; D005832:Genital Diseases, Male / Q000601:surgery*; D006801:Humans; D008012:Lidocaine; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011318:Prilocaine; D014860:Warts / Q000601:surgery*
D000779:Anesthetics, Local; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine