Local anesthesia of genital mucosa with a lidocaine/prilocaine combination cream before laser therapy of human papillomavirus lesions.
The objective was to assess the efficacy of the lidocaine 2. 5%/prilocaine 2.5% combination cream during CO2 laser vaporisation treatment of human papillomavirus-related anogenital lesions. The cream was applied 1 to 30 min beforehand. Patients assessed pain using a visual analogue scale. Regardless of the site and lesion surface area, anaesthesia was greatest when the cream was applied 5 to 15 min before treatment. Extra-cervical lesions (vagina, vulva, perineum, anus) were globally less painful than cervical lesions. Lesion surface area is a decisive factor in pre-operative anaesthesia. Small surface-area lesions (< 1 cm2) had significantly greater anaesthesia than larger surface area-lesions (> 5 cm2) (p<0.00001). The study cream proved particularly useful for complete anaesthesia in ambulatory treatment of anal (70%) and urethral (60%) mucosa lesions compared to the uterine cervix (p = 0.03). In terms of anaesthetic efficacy and cost-related benefits, the lidocaine/prilocaine cream is an effective and interesting alternative to locoregional intra-lesional anaesthesia or even to general anaesthesia, for excision and destruction of human papillomavirus-related anogenital lesions.
Monsonego
J
J
Department of Colposcopy, Institut Alfred-Fournier, 25, boulevard Saint-Jacques, 75014 Paris, France. admin@eurogin.com
Semaille
C
C
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D000772:Anesthesia, Local / Q000379:methods*; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000628:therapy*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009824:Ointments / Q000008:administration & dosage; D010147:Pain Measurement; D027383:Papillomaviridae / Q000302:isolation & purification*; D011318:Prilocaine / Q000008:administration & dosage*; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000628:therapy*
D004338:Drug Combinations; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine