title: EMLA and Lidocaine Spray: A Comparison for Surgical Debridement in Venous Leg Ulcers.
abstract: Objective:In this study the author proposes to compare eutectic mixture of local anesthetics (EMLA) and an odontoiatric spray solution of 10% Lidocaine (Ecocain) for surgical debridement in venous leg ulcers.Approach:Fifty patients were recruited and randomly assigned into two groups (A, B). All of them have venous leg ulcer in the medial and/or lateral malleolar region. Group A: topical anesthetic EMLA with film occlusion. Group B: topical anesthesia with Ecocain. The author proceeded to surgical debridement after local anesthesia. A questionnaire and a visual analog scale (VAS) were administered to assess the amount of pain felt during the debridement and during the following 6 h.Results:The analysis of the VAS revealed no major significant differences statistically. The analysis of the questionnaires showed patients treated with Ecocain took more analgesic drugs. Analysis of the timing and quality of procedure showed that Ecocain reduced the timing of debridement and dressing change, improving the outpatient management and patient compliance.Innovations:For rapid debridement, the most appropriate is to use Ecocain.Conclusion:Methods of local anesthesia are multiple and must be identified according to the needs of the patient and the surgeon trying to get the best anesthesia with minimal use of time and resources.
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Roberto
authors.initials: R
authors.lastname: Cuomo
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Carlo
authors.initials: C
authors.lastname: D'Aniello
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Luca
authors.initials: L
authors.lastname: Grimaldi
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nisi
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Gaia
authors.initials: G
authors.lastname: Botteri
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Irene
authors.initials: I
authors.lastname: Zerini
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Santa Maria Alle Scotte Hospital, University of Siena , Siena, Italy .
authors.forename: Cesare
authors.initials: C
authors.lastname: Brandi