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ANALGESIA

Eutectic Mixture of Local Anesthetic (EMLA®) Decreases Pain During Humeral Block Placement in Nonsedated Patients

David Samson, MD^*, Vincent Minville, MD^*, Clément Chassery, MD^*, Luc Nguyen, MD^*, Antoine Pianezza, MD^*, Olivier Fourcade, MD, PhD^*, Anna Rabinowitz, MS, and Kamran Samii, MD^*

From the *Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Paul Sabatier, Toulouse, France; and Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

Address correspondence and reprint requests to Vincent Minville, MD, Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, Rangueil Hospital-Orthopedic Section, 1, Avenue Jean Poulhès, Toulouse, France. Address e-mail to vincentminville{at}yahoo.fr.

Abstract

BACKGROUND: We evaluated the potential role of an euctectic mixture of local anesthetic (EMLA®) cream application before performing midhumeral block.

METHODS: Sixty patients undergoing surgery distal to the elbow amenable to a humeral block were prospectively recruited for the study. The patients were randomly allocated to 1 of 3 groups: Group E: topical EMLA cream 60 min before block plus 2 mL IV normal saline 5 min before procedure; Group P: topical sham cream plus 2 mL IV normal saline, and Group S: topical sham cream plus 0.1 µg/kg of sufentanil in 2 mL solution IV. Pain experienced during skin puncture, and overall pain for the whole procedure were rated using a 100-mm visual analog scale (0: no pain to 100: worst pain).

RESULTS: Patients in Group E experienced less pain compared with those in Groups P and S (5 ± 3 mm vs 33 ± 20 mm and 30 ± 18 mm, respectively, P < 0.0001). The pain experienced throughout the complete humeral block was more substantial in Group P than in Group E (P = 0.01).

CONCLUSION: The patients who received EMLA cream had less pain with needle puncture as well as throughout the performance of humeral block.

This article has been cited by other articles:

				M. J. O'Sullivan Patient Comfort in Regional Anesthesia Anesth. Analg., January 1, 2008; 106(1): 349 - 349. [Full Text] [PDF]

				V. Minville and D. Samson Patient Comfort in Regional Anesthesia Anesth. Analg., January 1, 2008; 106(1): 349 - 350. [Full Text] [PDF]