title: Eutectic mixture of local anesthetic (EMLA) decreases pain during humeral block placement in nonsedated patients.
abstract: BACKGROUND
  We evaluated the potential role of an euctectic mixture of local anesthetic (EMLA) cream application before performing midhumeral block.
  
  
  METHODS
  Sixty patients undergoing surgery distal to the elbow amenable to a humeral block were prospectively recruited for the study. The patients were randomly allocated to 1 of 3 groups: Group E: topical EMLA cream 60 min before block plus 2 mL IV normal saline 5 min before procedure; Group P: topical sham cream plus 2 mL IV normal saline, and Group S: topical sham cream plus 0.1 microg/kg of sufentanil in 2 mL solution IV. Pain experienced during skin puncture, and overall pain for the whole procedure were rated using a 100-mm visual analog scale (0: no pain to 100: worst pain).
  
  
  RESULTS
  Patients in Group E experienced less pain compared with those in Groups P and S (5 +/- 3 mm vs 33 +/- 20 mm and 30 +/- 18 mm, respectively, P < 0.0001). The pain experienced throughout the complete humeral block was more substantial in Group P than in Group E (P = 0.01).
  
  
  CONCLUSIONS
  The patients who received EMLA cream had less pain with needle puncture as well as throughout the performance of humeral block.
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier, Toulouse, France.
authors.forename: David
authors.initials: D
authors.lastname: Samson
authors.forename: Vincent
authors.initials: V
authors.lastname: Minville
authors.forename: Clément
authors.initials: C
authors.lastname: Chassery
authors.forename: Luc
authors.initials: L
authors.lastname: Nguyen
authors.forename: Antoine
authors.initials: A
authors.lastname: Pianezza
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
authors.forename: Anna
authors.initials: A
authors.lastname: Rabinowitz
authors.forename: Kamran
authors.initials: K
authors.lastname: Samii
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D006811:Humerus / Q000502:physiology / Q000601:surgery; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D011318:Prilocaine / Q000008:administration & dosage*; D011446:Prospective Studies; D014851:Wakefulness / Q000502:physiology
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine