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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In most boys referred for circumcision preputial adhesions are the only problem, but these can predispose to recurrent balanitis. A simple technique using Emla cream (eutectic mixture of lignocaine and prilocaine) has been devised which allows the adhesions to be separated painlessly in the outpatient clinic. The technique was used on 39 boys aged 2 to 12 years referred for circumcision, none of whom had a retractable foreskin. The cream was applied under an occlusive dressing and left for 60 minutes before the adhesions were separated with a probe and a gauze swab. The procedure was completely pain free in 32 boys. One boy had to undergo a repeated procedure because he failed to follow the advice regularly to retract his foreskin in the three weeks after the procedure. Only one boy had to undergo circumcision later because of fibrous phimosis. In many boys referred for circumcision separation of preputial adhesions is all that is needed, and the use of this local anaesthetic technique avoids the need for general anaesthesia.
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PMID:Save the prepuce. Painless separation of preputial adhesions in the outpatient clinic. 313 22

The relative efficiency of 2 topical anaesthetic agents in controlling the pain arising from myringotomy and grommet insertion has been assessed by a prospective, single blind controlled trial. The 2 anaesthetics were 5% cocaine and a new lignocaine and prilocaine mixture named Emla. Following a standardized anaesthetic procedure the pain arising from myringotomy, aspiration of the middle ear and subsequent insertion of a grommet was recorded by the patient on a linear analogue scale. A multivariate analysis was performed to assess the factors which significantly affected the pain levels. Only the type of anaesthetic used played a major role, with Emla giving significantly better anaesthesia than cocaine.
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PMID:An evaluation of topical anaesthesia for myringotomy. 322 90

Recombinant human erythropoietin (rHuEpo) is used to correct anaemia in dialysis patients. Subcutaneous administration of rHuEpo may be associated with pain at the injection site. This study assessed the pain of subcutaneous infiltration of two different preparations of rHuEpo, alpha and beta, and the value of a local anaesthetic (Emla) cream, in reducing the pain of infiltration. Forty-eight haemodialysis patients were enrolled into a double-blind, placebo-controlled, paired-comparison study. Pain was assessed using a visual analogue scale, a verbal descriptive scale and a direct comparison between paired treatments. Subcutaneous injection of rHuEpo alpha was more painful than rHuEpo beta (P < 0.001); using placebo cream 42% of patients described the pain of rHuEpo alpha as severe or very severe, whereas none of the patients found rHuEpo beta so painful. Application of Emla for at least 2 h prior to injection resulted in a significant reduction in the pain of both preparations, but was unable to reduce the pain of rHuEpo alpha to that of rHuEpo beta. Subcutaneous injection of rHuEpo alpha is more painful than rHuEpo beta, even after application of Emla. Although the discomfort of rHuEpo beta is graded as very mild by most adult patients the use of Emla is associated with a significant reduction in discomfort, which may be of benefit to paediatric patients.
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PMID:Pain after subcutaneous injection of recombinant human erythropoietin: does Emla cream help? 955 Jun 87

Epicutaneous application of the anaesthetic cream Emla (lignocaine and prilocaine), to induce percutaneous anaesthesia in 38 patients scheduled for eyelid skin surgery is presented. The cream was applied 60 to 90 minutes before operation. In 36 out of the 38 patients (94.8%) no supplementary analgesia was required. The pain during the procedure was rated either as no pain in 29 patients (76.3%), slight pain in five patients (13%), moderate pain in two patients (5.2%), and severe pain in two patients (5.2%). Percutaneous anaesthesia induced by Emla cream is a useful and painless alternative method for analgesia in eyelid skin surgery.
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PMID:Percutaneous anaesthesia with a lignocaine-prilocaine cream (Emla) for eyelid skin surgery. 814 37

The use of Emla cream in the 1980s has enabled many procedures to be carried out without unnecessary pain or discomfort. Its various potential uses have been evaluated in many different specialties. This article reviews the application of Emla that have been found to be effective.
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PMID:Emla cream and its current uses. 795 55

The purpose of this study was to investigate the relative efficacy of Emla cream (a eutectic formulation of lignocaine and prilocaine) and Bonain's solution (equal amounts of cocaine hydrochloride, menthol and phenol) as local anesthetic agents to the tympanic membrane. Fifty patients undergoing bilateral tympanocentesis were included. The patients were used as their own controls. One tympanic membrane was anesthetized with Emla cream and the other with Bonain's solution. The operating microscope was used. After a 30 min analgesic time, tympanocentesis was performed with aspiration of middle ear secretions. Each patient was then asked to fill in a questionnaire that graded the severity of pain experienced: none, very mild, mild, moderate or severe. Findings showed that Bonain's solution was more effective in tympanocentesis. All patients experienced no pain to very mild pain. With Emla cream 15 of 50 patients experienced mild to moderate pain. No significant side effects occurred with either anesthetic agent.
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PMID:A comparison of topical Emla cream with Bonain's solution for anesthesia of the tympanic membrane during tympanocentesis. 873 75

The efficacy of the anesthesia by the Emla cream (a mixture of lydocaine and prylocaine) has been tested on the cervix uteri and the vulva before laser treatment of warts and intraepithelial neoplasia. Five of the six women treated for vulvar warts did not feel any pain during laser treatment after the application of the cream. On the cervix, the pain was evaluated on a median of 9 on a visual scale going from 0 to 100, compared to a median of 25 for women treated without local anesthesia. The efficacy of local anesthesia was best after 4 minutes. The local anesthesia by the Emla cream seems to constitute a real progress in the patient's tolerance of local destructive treatment of cervical and vulvar warts and intraepithelial neoplasia.
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PMID:[Effectiveness of local anesthesia using EMLA cream for laser treatment of cervical and vulvar lesions]. 947 Dec 90

This multicentre, double-blind, placebo-controlled, parallel-group study assessed the efficacy and safety of using Emla (lignocaine/prilocaine) anaesthetic cream to achieve pain control during sharp debridement of chronic leg ulcers of arterial, venous or arteriovenous aetiology. A total of 101 patients (51 Emla, 50 placebo), aged 29-99 years, who had experienced pain associated with previous debridement were included. Patients with an amide anaesthetic allergy, anaesthetic diabetic ulcers, or ulcers > 50 cm2 were excluded. Debridement was initiated approximately 30 minutes after the application of a thick layer of Emla or placebo cream to an ulcer occluded with a plastic wrap. The patient and investigator assessed the pain associated with debridement on a 100 mm visual analogue scale (VAS). The median patient VAS scores were 18 mm and 53.5 mm in the Emla and placebo groups, respectively (p < 0.0001). The corresponding investigator values in the two groups were 20 mm and 49.5 mm, respectively (p = 0.004). Local reactions were mainly transient and mild, and were observed in roughly the same percentage of placebo and Emla-treated patients. After a 30-minute application Emla cream significantly reduced the pain of debridement compared with the placebo.
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PMID:Using a topical anaesthetic cream to reduce pain during sharp debridement of chronic leg ulcers. 1296 31

Pain causes numerous physiological changes in neonates. All invasive procedures induce undesirable stress responses; theses responses can, however, be eliminated or reduced by a judicious use of analgesia. Even though a large number of analgesics and sedatives are currently available, most of them have not been studied in the neonate. At present, a precise understanding of the pharmacological mechanisms of analgesics is difficult because many interactions still remain unknown in the term and premature neonate. This article describes the main analgesics and sedative agents used in the neonate: morphine, fentanyl, sufentanil, alfentanil, nalbuphine, ketamine, midazolam, propofol, acetaminophen, and Emla cream. After a review of the literature regarding these drugs, some practical advices and suggestions for the treatment of procedure-induced pain, and background sedation/analgesia for ventilated neonates are given. It is also stated in this article that the best way to soothe pain in neonates is to combine non pharmacological and pharmacological strategies. At the national level, written guidelines should be prepared in order to improve pain management in the neonate.
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PMID:[Pain in neonates: pharmacological treatment]. 1641 96

Topical anesthetics based on a combination of 2.5% lidocaine and 2.5% prilocaine are efficient in eliminating pain from needle stick when placed on skin and oral mucosa. This suggests their application in soft tissue lacerations before suturing to enable pain-free exploration and suturing of traumatic lacerations without prior injection needle stick. The aim of the present study was to study the healing of experimental oral lacerations after topical anesthetic substances were placed in the lacerations. Thirty-six standardized incisions were made bilaterally in the lower and the upper labial mucosa of nine white New Zealand rabbits. All wounds were intentionally contaminated with saliva to simulate laceration wounds in trauma situation. EMLA cream and Oraqix thermosetting gel were applied into 30 lacerations and six lacerations were left untreated as control. In some lacerations the topical anesthetic agent was left in the wound, while in others they were rinsed off by saline before suturing the laceration wound. The rabbits were then killed after 3 days, 2 weeks and 4 weeks of healing and the lips were processed for histological evaluation. Similar normal histological healing patterns were seen in wounds in which EMLA and Oraqix were applied compared with control lacerations at all stages of healing. No adverse tissue or foreign body reactions were seen in any of the lacerations. We conclude that EMLA and Oraqix can be used in oral mucosal lacerations prior to suturing without the risk of adverse tissue reaction.
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PMID:Healing pattern of experimental soft tissue lacerations after application of novel topical anesthetic agents - an experimental study in rabbits. 1817 61


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