EMLA cream for carpal tunnel syndrome: how it compares with steroid injection.
BACKGROUND
A standard treatment option for carpal tunnel syndrome (CTS) is local injection of anesthetic-corticosteroid. This clinical trial was designed to compare the safety and efficacy of daily application of the EMLA cream (lidocaine 2.5% plus prilocaine 2.5%) with that of a single injection of methyl prednisolone acetate (Depo-Medrol) 40 mg.


METHODS
In this randomized, parallel-group, open-label, single-center, case-controlled, prospective study, 65 participants (70 hands) aged 18-75 years with clinical & electrodiagnostic evidences of CTS were randomized to receive either the EMLA cream (n = 30 patients, 35 hands, group 1) or one injection of methylprednisolone acetate 40 mg at wrist (n = 35 patients, group 2). Outcome assessments included the visual analog scale and clinical assessment.


RESULTS
After 4 weeks of treatment, patients in both groups reported significant changes (P < 0.001) in pain intensity. Both treatments were well tolerated, with treatment-related adverse events (AEs) reported in 2 patients in group 1 (5.7%) and 10 patients in group 2 (28.5%) No systemic treatment-related AEs were observed with the EMLA cream.


CONCLUSIONS
EMLA cream was effective in reducing pain associated with CTS and well tolerated and it may offer patients with CTS an effective, noninvasive symptomatic treatment.
Moghtaderi
A R
AR
Shiraz University of Medical Sciences, Shiraz, Iran. moghtaderia@yahoo.com
Jazayeri
S M
SM
Azizi
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000627:therapeutic use*; D002349:Carpal Tunnel Syndrome / Q000188:drug therapy*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010147:Pain Measurement; D010865:Pilot Projects; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D011318:Prilocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D019162:Anesthetics, Combined; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine; D011239:Prednisolone