THE USE OF EMLA CREAM AND 1-PERCENT LIDOCAINE INFILTRATION IN MEN FORRELIEF OF PAIN ASSOCIATED WITH THE REMOVAL OF GENITAL WARTS BY CRYOTHERAPY

Background: Surgical procedures used to remove genital warts (cryother apy, electrodesiccation) are painful. Attempts to reduce the discomfor t of surgery by prior lidocaine infiltration anesthesia are compromise d by the pain of the infiltration. Objective: Our purpose was to deter mine the efficacy of topically applied lidocaine/prilocaine cream to r educe the pain of lidocaine infiltration and the pain associated with cryotherapy to remove genital warts. Methods: Men, scheduled for remov al of genital warts by cryotherapy, were randomly selected to receive one of three treatments: (1) lidocaine/prilocaine cream application, ( 2) 1% lidocaine infiltration, and (3) lidocaine/prilocaine cream appli cation followed by infiltration of 1% lidocaine. Results: Application of lidocaine/prilocaine cream for 15 minutes markedly reduced the pain of lidocaine infiltration. The combination of lidocaine/prilocaine cr eam followed by infiltration of 1% lidocaine gave greater pain relief from the cryotherapy than did either anesthetic alone. Conclusion: The application of lidocaine/prilocaine cream as an adjunct to lidocaine infiltration reduced the pain of infiltration and the pain associated with cryotherapy for the removal of genital warts.