Evaluation of eutectic lidocaine/prilocaine cream (EMLA) for steroid joint injection in children with juvenile rheumatoid arthritis: a double blind, randomized, placebo controlled trial.
OBJECTIVE
To evaluate the efficacy of eutectic lidocaine/prilocaine cream (EMLA) in reducing the pain associated with steroid joint injection in children with juvenile arthritis.


METHODS
A randomized, double blind, placebo controlled parallel group trial. Thirty-one children (ages 8-18 yrs) scheduled for steroid injection into a knee were randomized into groups having either 2.5 g lidocaine/prilocaine cream or placebo cream applied to the injection site 60-90 min before the procedure. Patients assessed the pain associated with initial needle insertion and subsequent steroid injection using a 10 cm visual analog scale.


RESULTS
No significant difference was found in the pain reported after needle insertion or steroid injection between the lidocaine/prilocaine cream group (n = 17) and the placebo group (n = 14). There was a trend toward an association of lower median scores with the pain of steroid injection in the lidocaine/prilocaine group (6 mm) compared with the placebo group (22 mm).


CONCLUSIONS
Application of 2.5 g lidocaine/prilocaine cream for 60-90 min had no statistically significant analgesic effect on pain associated with injections of steroids into the knees of children with juvenile arthritis.
Uziel
Yosef
Y
Divisions of Rheumatology and Clinical Pharmacology and Toxicology, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada.
Berkovitch
Matitiahu
M
Gazarian
Madlen
M
Koren
Gideon
G
Silverman
Earl D
ED
Schneider
Rayfel
R
Laxer
Ronald M
RM
D000293:Adolescent; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D010146:Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D010919:Placebos; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects; D013256:Steroids
D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D000077442:Lidocaine, Prilocaine Drug Combination; D010919:Placebos; D013256:Steroids; D011318:Prilocaine; D008012:Lidocaine