Eutectic mixture of local anesthetic (EMLA) decreases pain during humeral block placement in nonsedated patients.
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.
Samson
David
D
Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier, Toulouse, France.
Minville
Vincent
V
Chassery
Clément
C
Nguyen
Luc
L
Pianezza
Antoine
A
Fourcade
Olivier
O
Rabinowitz
Anna
A
Samii
Kamran
K
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
D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine