Evaluation of the analgesic efficacy of EMLA cream in volunteers with differing skin pigmentation undergoing venipuncture

Background and Objectives. Lidocaine/prilocaine cream (EMLA) applied to int act skin for 60 minutes has been shown to reduce venipuncture pain. Recent studies have suggested that lidocaine/prilocaine cream is less effective on heavily pigmented skin. The objective of this study was to evaluate the to pical anesthetic efficacy of lidocaine/ prilocaine cream in volunteers with varying skin pigmentation types. Methods. Sixty volunteers were enrolled i nto each of three groups based on skin pigmentation history. Subjects were randomized to receive lidocaine/prilocaine cream onto the antecubital fossa of one arm and placebo cream on the comparable location of the other arm f or either 60, 90, or 120 minutes prior to venipuncture. Assessments of perc eived pain associated with each venipuncture were made by the subject using a visual analog scale. Results. Lidocaine/prilocaine cream applied for 60 minutes significantly (P < .0001) reduced the pain of venipuncture compared to placebo regardless of the skin pigmentation type. Pain reduction did no t differ significantly across skin types (P = .7986). Additional exposure u p to 120 minutes did not change the efficacy of EMLA cream. Conclusions. Li docaine/prilocaine cream is a safe and effective topical anesthetic for red ucing pain associated with venipuncture in individuals, regardless of skin pigmentation.