Efficacy of a eutectic mixture of local anesthetics as a topical anesthetic in minor otologic procedures

Abstract

A eutectic mixture of local anesthetics (EMLA), prepared as a cream, is an oil-in-water emulsion of 2 anesthetic agents lidocaine and prilocaine. Several clinical applications of EMLA cream, its effectiveness as a topical anesthetic, and its safety profile have been previously reported. We report our experience with EMLA cream in 17 adult and 24 pediatric patients. We find EMLA to be the preferred anesthetic for performing minor outpatient otologic procedures in adults. We also find EMLA to be a safe, well-tolerated alternative to general anesthesia in some pediatric patients. Potential cost savings of EMLA cream during pediatric myringotomies in the clinic are also discussed.

Office Insertion of Tympanostomy Tubes and the Role of Automated Insertion Devices

“…23 A eutectic mixture of local anesthetics is also effective but can be difficult to apply in children and requires 30 to 45 minutes for anesthesia onset. 24 Iontophoresis, which requires significant child cooperation, uses a low-level electrical current to promote absorption of lidocaine solution by the tympanic membrane without serious adverse events or ototoxicity. 25,26 Acetaminophen, administered 30 to 60 minutes before tube insertion, has shown comparable efficacy to topical lidocaine for postprocedure pain relief.…”

“…Phenol applied sparingly to the tympanic membrane offers safe and rapid anesthesia, 21 , 22 although a copious volume can result in necrosis and facial paralysis 23 . A eutectic mixture of local anesthetics is also effective but can be difficult to apply in children and requires 30 to 45 minutes for anesthesia onset 24 . Iontophoresis, which requires significant child cooperation, uses a low‐level electrical current to promote absorption of lidocaine solution by the tympanic membrane without serious adverse events or ototoxicity 25 , 26 .…”

The Influence of a Eutectic Mixture of Lidocaine and Prilocaine on Minor Surgical Procedures

“…Various studies have confirmed the effectiveness of EMLA in reducing pain from needle sticks, including those associated with blood sampling and intravenous insertion 4,5 . In addition, EMLA has provided sufficient analgesia for simple dermatologic procedures, harvesting of split‐thickness skin grafts, debridement of venous leg ulcers, transrectal biopsy of prostate, and minor otologic and gynecologic procedures 6–9 . However, there have been contradictory reports regarding the efficacy of EMLA in reducing the discomfort associated with local anesthetic infiltration 10,11 .…”

“…4,5 In addition, EMLA has provided sufficient analgesia for simple dermatologic procedures, harvesting of split-thickness skin grafts, debridement of venous leg ulcers, transrectal biopsy of prostate, and minor otologic and gynecologic procedures. [6][7][8][9] However, there have been contradictory reports regarding the efficacy of EMLA in reducing the discomfort associated with local anesthetic infiltration. 10,11 These conflicting results prompted the authors to study the usefulness of EMLA in preventing the pain associated with the infiltration of local anesthetic for minor surgical procedures.…”

Preparação e caracterização de uma mistura eutética baseada em um derivado de óleo essencial extraído do Syzygium aromaticum L.

“…Certos princípios ativos apresentam problemas quanto à pequena solubilidade em água, como por exemplo, a digoxina e a lidocaína. Atualmente, a indústria farmacêutica enfrenta problemas em formulações farmacêuticas devido ao grande número de fármacos empregando princípios ativos com diminuída solubilidade em água e pouca biodisponibilidade oral 12,28 .…”