EMLA and ear surgery: is it possible to achieve full-thickness anesthesia with EMLA?
BACKGROUND
Topical local anesthetic applications offer painless, effective analgesia with slow onset but prolonged duration and minimal side effects. EMLA (Eczacibasi Pharmaceuticals, Istanbul, Turkey) is the most universally used topical local anesthetic.


OBJECTIVE
The aim of this prospective, randomized, double-blind study is to evaluate the efficacy of EMLA on total anesthesia of the external ear.


METHODS
Twenty-two patients with helical lesions were divided into two groups. Group A received EMLA on both the anterior and posterior surfaces of the ear, and group B received EMLA on only one side of the ear. After 120 minutes of occlusive dressing, the surgery was performed. The short form of the McGill Pain Questionnaire and a numerical visual analog scale were used to measure overall pain quality and intensity during and at the end of surgery.


RESULTS
Visual analog scale scores (four for group A and six for group B6) between two groups using Student's t-test (p=0210) and concerning McGill Pain Questionnaire scores with Wilcoxon signed ranks test (p=0.058) between two groups showed no statistical significant difference.


CONCLUSIONS
It seems that EMLA cream is not a good and first option for achieving full anesthesia on the ear because of its poor anesthetic effect. We do not consider EMLA cream to be clinically useful for major surgical attempt on the ear.
Ankara Training and Research Hospital, Plastic and Reconstructive Surgery Department, Ankara, Turkey. nsarifakioglu@yahoo.com
Nedim
N
Sarifakioglu
Ahmet
A
Terzioglu
Bülent
B
Cigsar
Gürcan
G
Aslan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D004311:Double-Blind Method; D004431:Ear, External / Q000601:surgery*; D005260:Female; D006801:Humans; D008012:Lidocaine; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011318:Prilocaine; D011446:Prospective Studies
D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine