Local anaesthesia of genital mucosa with a lidocaine/prilocaine combination cream before laser therapy of human papillomavirus lesions

The objective was To assess the efficacy of the lidocaine 2.5%/prilocaine 2 .5% combination cream during CO2 laser vaporisation treatment of human papi llomavirus-related anogenital lesions. The cream was applied 1 to 30 min be forehand. Patients assessed pain using a visual analogue scale. Regardless of the site and lesion surface area, anaesthesia was greatest when the crea m was applied 5 to 15 min before treatment. Extra-cervical lesions (vagina, vulva, perineum, anus) were globally less painful than cervical lesions. Lesion surface area is a decisive factor in pre-operative anaesthesia, Smal l surface-area lesions (< 1 cm(2)) had significantly greater anaesthesia th an larger surface area-lesions (> 5 cm(2)) (p < 0.00001). The study cream p roved particularly useful for complete anaesthesia in ambulatory treatment of anal (70%) and urethral (60%) mucosa lesions compared to the uterine cer vix (p = 0.03). In terms of anaesthetic efficacy and cost-related benefits, the lidocaine/p rilocaine cream is an effective and interesting alternative to locoregional intra-lesional anaesthesia or even to general anaesthesia, for excision an d destruction of human papillomavirus-related anogenital lesions.