title: EMLA cream effectively reduces the pain of spinal needle insertion.
abstract: OBJECTIVE
  EMLA cream is an effective topical anesthetic, which is commonly used for analgesia during venous cannulation in the pediatric population. This study was designed to compare the efficacy of EMLA cream with that of infiltration with lidocaine in relieving the pain associated with administration of spinal anesthesia.
  
  
  METHODS
  The patient population consisted of 41 ASA status I and II women scheduled for postpartum tubal ligation. Spinal anesthesia was administered with a 25-gauge spinal needle via a 20-gauge introducer. The patients were randomly allocated to receive either EMLA cream for a minimum of 30 minutes or infiltration with 3 mL of 1% lidocaine prior to spinal needle insertion. Pain during spinal needle insertion was assessed immediately after each procedure by a 10-cm visual analog scale.
  
  
  RESULTS
  Pain scores were significantly lower in the EMLA group (mean, 1.5) than in the lidocaine group (mean, 3.52) (P < .001). The number of patients satisfied with the method of analgesia was significantly higher in the EMLA than in the lidocaine group (90% vs 55%, P < .05).
  
  
  CONCLUSIONS
  EMLA cream is an effective alternative to lidocaine infiltration for analgesia during the administration of spinal anesthesia when using a 25-gauge spinal needle via a 20-gauge introducer. Application of EMLA cream for at least 30 minutes prior to spinal needle insertion is adequate to provide good analgesia during needle insertion.
authors.affiliation: Department of Anesthesiology and Rain Management, Parkland Memorial Hospital, Dallas, TX, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Sharma
authors.forename: N M
authors.initials: NM
authors.lastname: Gajraj
authors.forename: J E
authors.initials: JE
authors.lastname: Sidawi
authors.forename: K
authors.initials: K
authors.lastname: Lowe
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D010147:Pain Measurement; D017060:Patient Satisfaction; D011318:Prilocaine / Q000008:administration & dosage*; D013129:Spinal Puncture; D013246:Sterilization, Tubal
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine