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KMID : 0356920080540040395
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Korean Journal of Anesthesiology
2008 Volume.54 No. 4 p.395 ~ p.399
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The Analgesic Efficacy of a 5% Eutectic Mixture of Lidocaine and Prilocaine Prior to Insertion of Spinal and Epidural Block
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Kim Yeon-Jae
Chung Mi-Hwa
Choi Young-Ryong
Park Hyu-Jung
Won Rim-Soo
Lee Jin-Young
Jung Jin-Kyung
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Abstract
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Background : We evaluated the analgesic efficacy of a 5% eutectic mixture of lidocaine and prilocaine (EMLA?) topically applied before performing skin puncture for spinal or epidural anesthesia.
Methods : The patient population consisted of 75 ASA physical status 1 and 2 adults scheduled for operations of the lower abdominal region, the perineal region or the lower extremities. The patients were randomly allocated to one of five groups of equal size: group A - topical application of EMLA? cream 120 min before spinal block; group B - subcutaneous infiltrationof 2 ml of 2% lidocaine immediately before spinal block; group C - no pretreatment before spinal block; group D - topical application of EMLA? cream 120 min before epidural block; and group E - subcutaneous infiltration of 2 ml of 2% lidocaine immediatelybefore epidural block. Pain experienced during the whole procedure was rated using a 10 cm visual analogue scale.
Results : Patients in group A experienced less pain compared with those in groups B and C (2.0 ± 1.9 cm vs 4.1 ± 1.9 cm and 3.9 ± 2.2 cm, respectively; P ＜ 0.05). However there was no significant difference between group D and group E (3.6 ± 2.4 cm vs 4.1 ± 2.5 cm). The patients in group A and group D were highly satisfied with the method of analgesia (P ＜ 0.05).
Conclusion : EMLA? cream is an effective alternative to subcutaneous infiltration of local anesthetic for analgesia during skin puncture using a 25 G spinal needle. It provides insufficient analgesia however for epidural anesthesia. (Korean J Anesthesiol 2008; 54: 395∼99)
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KEYWORD
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epidural anesthesia, eutectic mixture of lidocaine and prilocaine, infiltration, lidocaine, spinal anesthesia.
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