title: Use of a topical anesthetic cream (EMLA) to reduce pain after hemorrhoidectomy.
abstract: OBJECTIVE
  Hemorrhoidectomy usually leads to severe postoperative pain that often causes urinary retention. Topical EMLA cream (lidocaine 2.5% and prilocaine 2.5%) has been used extensively in the clinical setting. This prospective study tested the effectiveness of EMLA cream for postoperative pain control after hemorrhoidectomy.
  
  
  METHODS
  Thirty patients admitted for hemorrhoidectomy were enrolled and randomly assigned into either a control group (n = 15) or EMLA group (n = 15). Postoperatively, the control group received approximately 5 g of neomycin ointment, and the EMLA group received approximately 5 g of EMLA. A visual analog scale (VAS) score was recorded on arrival in the postanesthesia recovery unit (PAR), after 2 hours in the PAR, on the first postoperative evening, and on the first postoperative morning. The requested frequency and dosage of meperidine, the first spontaneous voiding time, the frequency of single urinary catheterization, and a patient satisfaction score were also obtained.
  
  
  RESULTS
  The VAS score and frequency and dosage of meperidine injections were significantly lower in the EMLA group than in the control group (P < .01). The voiding time was significantly later in the control group (P = .04). The frequency of single catheterization was significantly lower in the EMLA group than in the control group (P = .03). Patient satisfaction with postoperative pain control was significantly higher in the EMLA group than in the control group (P < .01). No systemic complications were observed.
  
  
  CONCLUSIONS
  Topical EMLA cream decreased pain intensity and meperidine requests, reduced the frequency of single catheterizations, and improved patient satisfaction with postoperative pain management after hemorrhoidectomy in adults.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Jieh-Min
authors.initials: JM
authors.lastname: Shiau
authors.forename: Hao-Po
authors.initials: HP
authors.lastname: Su
authors.forename: Hung-Shu
authors.initials: HS
authors.lastname: Chen
authors.forename: Kuo-Chuan
authors.initials: KC
authors.lastname: Hung
authors.forename: Shung-Eing
authors.initials: SE
authors.lastname: Lin
authors.forename: Chia-Chih
authors.initials: CC
authors.lastname: Tseng
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use*; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000627:therapeutic use; D009824:Ointments; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011184:Postoperative Period; D011318:Prilocaine / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine; D009355:Neomycin