TOPICAL LIDOCAINE-PRILOCAINE CREAM (EMLA((R))) VERSUS LOCAL INFILTRATION ANESTHESIA FOR RADIAL ARTERY CANNULATION

In a randomized trial, we compared topical anesthesia by a lidocaine-p rilocaine cream (EMLA(R); Laboratorie ASTRA, Manterre, France) with su bcutaneous local lidocaine infiltration for radial artery cannulation. Patients included 538 adults scheduled for coronary angiography using a radial approach. EMLA(R) was applied 2 h before radial cannulation, and lidocaine infiltration was performed 5 min before cannulation. Th e primary end point was pain as assessed by a verbal numerical scale ( 0 = no pain, 10 = extreme pain). Pain was less severe in the EMLA(R) g roup than in the lidocaine infiltration group (Score of 2 vs 7; P = 0. 0001). Additional lidocaine infiltration was required significantly le ss frequently in the EMLA(R) group (relative risk 0.19). The failure r ate of cannulation was significantly lower in the EMLA(R) group (relat ive risk 0.38), and insertion time was shorter (4 versus 6 min). We co nclude that EMLA(R), compared with lidocaine infiltration, reduces pai n associated with radial artery cannulation and improves the success r ate of the procedure. Routine application of EMLA(R) should be perform ed in awake patients 2 h before radial artery cannulation. Implication s: In a randomized trial, we compared topical anesthesia by a lidocain e-prilocaine cream (EMLA(R)) with subcutaneous local lidocaine infiltr ation for radial artery cannulation in 538 adults patients. EMLA(R) re duced pain associated with radial artery cannulation and improved the success rate of the procedure.