title: A Double-Blind, Randomised, Placebo-Controlled Trial of EMLA® Cream (Eutectic Lidocaine/Prilocaine Cream) for Analgesia Prior to Cryotherapy of Plantar Warts in Adults.
abstract: BACKGROUND
  Cryotherapy with liquid nitrogen is an effective, safe and convenient form of treatment for plantar warts. EMLA® cream (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%) is a topical local anaesthetic agent that has proven to be effective and well tolerated in the relief of pain associated with various minor interventions in numerous clinical settings.
  
  
  METHODS
  In a single-centre, double-blind, randomised placebo-controlled study, 64 subjects were randomised into 2 groups. The subjects had a thick layer of EMLA® cream or placebo cream applied to pared plantar wart(s) and onto the surrounding margin of 1 mm to 2 mm under occlusion for 60 minutes prior to receiving cryotherapy. The pain of cryotherapy was evaluated by the subjects using a self-administered Visual Analogue Scale (VAS) immediately after the cryotherapy.
  
  
  RESULTS
  There was no statistical difference between the mean VAS score for EMLA® cream (47.0 ± 21.4 mm) and placebo (48.9 ± 22.0 mm). Those with more than 1 wart had a significantly higher VAS score than those with only 1 wart (59.1 ± 21.8 vs. 44.3 ± 20.4, P <0.05) but this did not affect the therapeutic effect of EMLA® cream prior to cryotherapy.
  
  
  CONCLUSIONS
  We conclude that the application of EMLA® cream prior to cryotherapy does not reduce the pain associated with cryotherapy.
authors.affiliation: Clinical Nursing Unit, National University Hospital, Singapore.
authors.forename: Siew Hui
authors.initials: SH
authors.lastname: Lee
authors.forename: Janthorn
authors.initials: J
authors.lastname: Pakdeethai
authors.forename: Matthias P H S
authors.initials: MP
authors.lastname: Toh
authors.forename: Derrick C W
authors.initials: DC
authors.lastname: Aw
mesh_terms: D000328:Adult; D000698:Analgesia; D000779:Anesthetics, Local / Q000627:therapeutic use*; D017679:Cryotherapy; D004311:Double-Blind Method; D005260:Female; D005533:Foot Dermatoses / Q000628:therapy*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011318:Prilocaine / Q000627:therapeutic use*; D014860:Warts / Q000628:therapy*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine