title: Using a topical anaesthetic cream to reduce pain during sharp debridement of chronic leg ulcers.
abstract: This multicentre, double-blind, placebo-controlled, parallel-group study assessed the efficacy and safety of using Emla (lignocaine/prilocaine) anaesthetic cream to achieve pain control during sharp debridement of chronic leg ulcers of arterial, venous or arteriovenous aetiology. A total of 101 patients (51 Emla, 50 placebo), aged 29-99 years, who had experienced pain associated with previous debridement were included. Patients with an amide anaesthetic allergy, anaesthetic diabetic ulcers, or ulcers > 50 cm2 were excluded. Debridement was initiated approximately 30 minutes after the application of a thick layer of Emla or placebo cream to an ulcer occluded with a plastic wrap. The patient and investigator assessed the pain associated with debridement on a 100 mm visual analogue scale (VAS). The median patient VAS scores were 18 mm and 53.5 mm in the Emla and placebo groups, respectively (p < 0.0001). The corresponding investigator values in the two groups were 20 mm and 49.5 mm, respectively (p = 0.004). Local reactions were mainly transient and mild, and were observed in roughly the same percentage of placebo and Emla-treated patients. After a 30-minute application Emla cream significantly reduced the pain of debridement compared with the placebo.
authors.affiliation: Division of Dermatology, McMaster University, Faculty of Health Sciences, St. Joseph's Hospital, Hamilton, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Rosenthal
authors.forename: F
authors.initials: F
authors.lastname: Murphy
authors.forename: R
authors.initials: R
authors.lastname: Gottschalk
authors.forename: M
authors.initials: M
authors.lastname: Baxter
authors.forename: B
authors.initials: B
authors.lastname: Lycka
authors.forename: K
authors.initials: K
authors.lastname: Nevin
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002908:Chronic Disease; D003646:Debridement / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000451:nursing*; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement; D011318:Prilocaine / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine