title: EMLA does not permit pain-free retrobulbar injection.
abstract: BACKGROUND
  Retrobulbar injection can be associated with significant pain, due to both needle insertion and deposition of the local anaesthetic solution. The local anaesthetic cream EMLA (eutectic mixture of local anaesthetics) which contains a mixture of lignocaine and prilocaine has been shown to reduce the pain associated with skin puncture. The efficacy of EMLA in alleviating the pain of retrobulbar injection for cataract surgery was assessed in this study.
  
  
  METHODS
  In this, randomised double-blind study, EMLA (n = 53) or lignocaine 5% ointment (n = 50) was administered to the inferior orbital margin at least 45 min before retrobulbar block in 103 patients. Pain assessed during retrobulbar block was marked subjectively by the patient on a 10-point numerical rating scale.
  
  
  RESULTS
  Median verbal pain scores were 3.0 with an interquartile range of 1.5-6.5 in the control group and 3.50 with an interquartile range of 2.0-6.0 in the EMLA(R) group (P = 0.67). There was no significant difference between the EMLA group and the lignocaine ointment group according to this pain assessment.
  
  
  CONCLUSIONS
  EMLA does not permit pain-free retrobulbar injection.
authors.affiliation: Department of Anaesthesiology, Dokuz Eylül University Medical School, Izmir, Turkey. bkuvaki@deu.edu.tr
authors.forename: B
authors.initials: B
authors.lastname: Kuvaki
authors.forename: N
authors.initials: N
authors.lastname: Gökmen
authors.forename: F
authors.initials: F
authors.lastname: Günenç
authors.forename: H
authors.initials: H
authors.lastname: Ceyhan Kara
authors.forename: H
authors.initials: H
authors.lastname: Uzümlü
authors.forename: G
authors.initials: G
authors.lastname: Ozden
authors.forename: M
authors.initials: M
authors.lastname: Söylev
authors.forename: E
authors.initials: E
authors.lastname: Gökel
mesh_terms: D000287:Administration, Topical; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002387:Cataract Extraction; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects; D011318:Prilocaine / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine