High-Energy Pulsed Light Source Hair Removal Device Used to Evaluate the Onset of Action of a New Topical Anesthetic

Altman, David A.; Gildenberg, Stuart

doi:10.1046/j.1524-4725.1999.99108.x

Cited by 24 publications

(13 citation statements)

References 6 publications

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“…Although EMLA cream and lidocaine HCl are both used as local anesthetics, lidocaine has demonstrated a more rapid onset and a longer duration compared with EMLA cream. 16 Regarding study design, the study of Borckardt et al 15 was limited, as it enrolled only healthy subjects (eg, patients with a medical or psychiatric diagnosis were not included), used EMLA cream in 2 participants, and had few rTMS sessions that were brief. The clinical application of rTMS for the treatment of depression will most likely involve a longer treatment course.…”

Section: Discussionmentioning

confidence: 99%

The Use of Topical Lidocaine to Reduce Pain During Repetitive Transcranial Magnetic Stimulation for the Treatment of Depression

Treviño¹,

McClintock²,

Husain³

2011

The Journal of ECT

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Repetitive transcranial magnetic stimulation (rTMS) is a form of neurostimulation therapy that was recently approved by the Food and Drug Administration for the treatment of depression. Repetitive transcranial magnetic stimulation is considered noninvasive and relatively safe; however, there have been reports of scalp pain during and at the site of stimulation. This case report documents the use of topical lidocaine to reduce scalp pain during rTMS administration. All patients had a diagnosis of major depressive disorder according to research diagnostic criteria and were washed off antidepressant medications before treatment. Patients were given active rTMS treatment during a masked, open-label, or long-term follow-up treatment schedule. Treatment was delivered to the left dorsolateral prefrontal cortex at 120% of the patient's observed motor threshold. Ten patients received 3000 magnetic pulses per session with an on time of 4 seconds and an off time of 26 seconds. Patients who reported pain during stimulation were given topical lidocaine HCl 2%, which was applied 20 minutes before treatment. Patients reported mixed outcomes of using topical lidocaine to reduce scalp pain during stimulation. Half of the patients reported no significant reduction in pain, whereas the other half indicated a noticeable decrease during rTMS. As a case report, our study has limited results. Given the recent approval of rTMS for the treatment of depression, additional studies are warranted to determine optimal methods of reducing scalp pain.

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Section: Discussionmentioning

confidence: 99%

The Use of Topical Lidocaine to Reduce Pain During Repetitive Transcranial Magnetic Stimulation for the Treatment of Depression

Treviño¹,

McClintock²,

Husain³

2011

The Journal of ECT

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“…6 In addition, ELA-Max has been shown to produce less vasoconstriction and result in a lower serum lidocaine level. 9,10 Package labeling for ELA-Max does not state that an occlusive dressing should be used. To help keep the cream in place, we chose to use a Tegaderm occlusive dressing.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Buffered Lidocaine Versus ELA-Max Before Peripheral Intravenous Catheter Insertions in Children

et al. 2004

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ABSTRACT. Background. Peripheral intravenous catheter (PIV) insertion is a common, painful experience for many children in the pediatric emergency department. Although local anesthetics such as injected buffered lidocaine have been shown to be effective at reducing pain and anxiety associated with PIV insertion, they are not routinely used. ELA-Max, a topical local anesthetic, has the advantage of needle-free administration but has not been compared with buffered lidocaine for PIV insertion.Objective. To compare the reduction of pain and anxiety during PIV insertion provided by subcutaneous buffered 1% lidocaine or topical ELA-Max in children.Methods. A randomized trial in children 4 to 17 years old undergoing PIV insertion with 22-gauge catheters was conducted. Children received either buffered lidocaine or ELA-Max. Buffered lidocaine was administered by using 30-gauge needles to inject 0.1 to 0.2 mL subcutaneously just before PIV insertion. ELA-Max was applied to the skin and occluded with Tegaderm 30 minutes before PIV insertion. Self-reported Visual Analog Scale (VAS) questionnaires (rating on a scale of 1-10; 1 ‫؍‬ no pain, anxiety) were completed by patients and their parents before PIV insertion to assess baseline perceptions about pain and anxiety associated with PIV insertion and immediately after PIV insertion to assess pain and anxiety associated with the experience. After PIV insertion, the nurse who inserted the PIV also completed a VAS questionnaire assessing technical difficulty and satisfaction with the local anesthesia. A blinded observer also completed a VAS questionnaire to assess pain and anxiety associated with the PIV insertion. Data were analyzed by using 2 and t tests.Results. Sixty-nine subjects were enrolled, and questionnaires were competed by all (mean age: 12.1 ؎ 4.5 years; 61% female). There were no differences for buffered lidocaine and ELA-Max groups in age, gender, race, prior IV experience, or baseline pain and anxiety. There were no significant differences between buffered lidocaine and ELA-Max in mean pain and anxiety after PIV insertion by patient, parent, and blinded observer ratings. Nurse ratings of technical difficulty, number of PIV-insertion attempts, and satisfaction with local anesthesia also were not significantly different for buffered lidocaine and ELA-Max groups.

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“…Another local anesthetic cream with a shorter onset of action (~30 min), ELA-Max, is also available and is composed of 4% liposomal lidocaine [ 71 ] . One study by Eichenfi eld and others observed comparable effi cacy between ELA-Max at 30 min and EMLA cream applied 60 min before the procedure [ 72 ] .…”

Section: Topical Analgesiamentioning

confidence: 99%

Regional Anesthetic Techniques for the Pediatric Patient

Fritz

Barnhouse

Ramadhyani

et al. 2011

Essentials of Regional Anesthesia

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High-Energy Pulsed Light Source Hair Removal Device Used to Evaluate the Onset of Action of a New Topical Anesthetic

Abstract: ELA-Max is an effective topical anesthetic agent comparable to EMLA under occlusion. It appears to be faster acting than EMLA, and along with its effectiveness without occlusion, may be an easier agent to use.

Cited by 24 publications

References 6 publications

The Use of Topical Lidocaine to Reduce Pain During Repetitive Transcranial Magnetic Stimulation for the Treatment of Depression

The Use of Topical Lidocaine to Reduce Pain During Repetitive Transcranial Magnetic Stimulation for the Treatment of Depression

A Comparison of Buffered Lidocaine Versus ELA-Max Before Peripheral Intravenous Catheter Insertions in Children

Regional Anesthetic Techniques for the Pediatric Patient

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