EMLA CREAM EFFECTIVELY REDUCES THE PAIN OF SPINAL NEEDLE INSERTION

Background and Objective. EMLA cream is an effective topical anestheti c, which is commonly used for analgesia during venous cannulation in t he pediatric population. This study was designed to compare the effica cy of EMLA cream with that of infiltration with lidocaine in relieving the pain associated with administration of spinal anesthesia. Methods . The patient population consisted of 41 ASA status I and II women sch eduled for postpartum tubal ligation. Spinal anesthesia was administer ed with a 25-gauge spinal needle via a 20-gauge introducer. The patien ts were randomly allocated to receive either EMLA cream for a minimum of 30 minutes or infiltration with 7 mL of 1% lidocaine prior to spina l needle insertion. Pain during spinal needle insertion was assessed i mmediately after each procedure by a 10-cm visual analog scale. Result s. Pain scores were significantly lower in the EMLA group (mean, 1.5) than in the lidocaine group (mean, 3.52) (P < .001). The number of pat ients satisfied with the method of analgesia was significantly higher in the EMLA than in the lidocaine group (90% vs 55%, P < .05). Conclus ion. EMLA cream is an effective alternative to lidocaine infiltration for analgesia during the administration of spinal anesthesia when usin g a 25-gauge spinal needle via a 20-gauge introducer. Application of E MLA cream for at least 30 minutes prior to spinal needle insertion is adequate to provide good anlagesia during needle insertion.