Topical lidocaine-prilocaine cream (EMLA) for thoracostomy tube removal.
We prospectively studied topical lidocaine-prilocaine cream (EMLA) versus IV morphine in a double-blinded, randomized fashion for pain relief during thoracostomy tube (chest tube; CT) removal. Adult patients who had undergone thoracotomy or median sternotomy were randomized to receive either EMLA cream over CT sites transdermally for 3 h or IV morphine 0.5 h before CT removal. Pain behavior was observed and rated before, during, and after CT removal. Pain behavior increased less in the topical EMLA group (mean +/- SE, 4.4+/-0.39) compared with the IV morphine group (6.0+/-0.38; P < 0.01). No signs of infection were noted at the CT sites 24 or 48 h after CT removal. We conclude that EMLA cream is more effective than IV morphine in preventing the pain associated with CT removal.


CONCLUSIONS
Postoperatively applying a topical anesthetic cream onto chest tube sites of chest surgery patients 3 h before chest tube removal is more effective than IV morphine in blunting pain response.
D000328:Adult; D000368:Aged; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D015505:Chest Tubes; D004311:Double-Blind Method; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D011318:Prilocaine / Q000627:therapeutic use*; D011446:Prospective Studies; D013907:Thoracostomy