title: Local anesthetic effects of Lidocaine cream: randomized controlled trial using a standardized prick pain.
abstract: BACKGROUND
  ELA-max (4% lidocaine) and EMLA cream (lidocaine-prilocaine 2.5%) are topicals used for superficial anesthesia. Only few studies have been published on their comparative effectiveness in close-to-practice pain models.
  
  
  OBJECTIVE
  (1) To evaluate the analgesic efficacy of lidocaine cream compared with lidocaine-prilocaine cream and placebo. (2) To assess the safety and tolerability.
  
  
  METHODS
  Randomized, three-arm, double-blind trial in 40 healthy volunteers comparing the anesthetic effects of Lidocaine and lidocaine-prilocaine cream to placebo at various time points (0-120 min). A standardized pain was induced by lancet pricks and measured by a visual analogue scale. Intra-individual comparison between the test areas was performed in a cross-over design.
  
  
  RESULTS
  Lidocaine showed significantly reduced pain compared to placebo at all assessment points. Pain reduction was achieved significantly earlier using lidocaine occlusively (30 min). No significant differences were found concerning the anesthetic efficacy of lidocaine and lidocaine-prilocaine cream. There were no relevant adverse events.
  
  
  CONCLUSIONS
  This study confirms that a topical preparation with 4% lidocaine is an effective and safe treatment option for superficial anesthesia. It supports the claim that an occlusive application is more rapid in action. 4% lidocaine is of value as a rapidly-acting local anesthetic for the treatment of minor surgical procedures.
authors.affiliation: CeDeF-Center for Dermatological Research, Institute for Health Services Research in Dermatology, University Clinics of Hamburg, Martinistr. 52, 20246 Hamburg, Germany. k.herberger@uke.uni-hamburg.de
authors.forename: Katharina
authors.initials: K
authors.lastname: Herberger
authors.forename: Karoline
authors.initials: K
authors.lastname: Krause
authors.forename: Kristina
authors.initials: K
authors.lastname: Maier
authors.forename: Ina
authors.initials: I
authors.lastname: Zschocke
authors.forename: Marc
authors.initials: M
authors.lastname: Radtke
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000328:Adult; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011318:Prilocaine / Q000008:administration & dosage*; D063465:Skin Cream; D055815:Young Adult
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D011318:Prilocaine; D008012:Lidocaine