A COMPARATIVE STUDY OF INJECTABLE LIGNOCAINE AND EMLA FOR SHORT DERMATOSURGERIES

Abstract

The topical anaesthetic available now a day can serve as a better alternative to injectible local anaesthetics for short dermatosurgical procedures. EMLA cream (eutectic mixture of local anesthetics), a topical local anesthetic cream has been shown to penetrate intact skin and provide analgesia of superficial layers. Few comparative studies are available which have shown EMLA to be an efficacious and acceptable option as local anaesthetic but as we know, pain and thence analgesia is a subjective perception and there can be wide interindividual variation in the results. So, this study was done to evaluate the anaesthetic potential of EMLA over lignocaine infiltration by applying both in the same individual. A total of thirty patients with warts, skin tags or molluscum which were planned for radiofrequency ablation were recruited to the study protocol. In each patient, in half of the lesions lignocaine was infiltrated and in the remaining EMLA was topically applied under occlusive dressing.The procedure was executed after 5 minutes of lignocaine infiltration and 30 minutes of EMLA application. Pain assessment was done using VAS (visual analogue score). Pain assessment was done both at the time of application and during the procedure. Extent of the pain was also assessed by the patient on a verbal rating scale. The results of the study show that lignocaine infiltration caused mild to moderate pain, while none of the patient experienced any type of pain on application of EMLA cream. The pain assessment during the anesthetics application, showed that lignocaine infiltration caused significantly higher VAS score in comparison with the EMLA application (<0.001). However, during the surgical procedure, EMLA applied patients experienced significantly higher VAS score in comparison with the lignocaine infiltrated patients (P<0.05). Howsoever, the patient’s acceptability to the EMLA application was found to be more in comparison with lignocaine. Adverse events were mild and comparable in both the groups. In conclusion EMLA is an efficacious alternative to lignocaine infiltration for shortdermatosurgery by radiofrequency and has better patient acceptability.

KEYWORDS: EMLA, Lignocaine, Radiofrequency ablations, VAS, Warts, Molluscum, Skin tags