Damage to tissue defenses by EMLA® cream

Adverse effects of local anesthetic infiltration on wound healing

“…One reported a mixed effect of increased infection at 4 days after EMLA, but also increased strength at 7 days after EMLA. 12 The latter effect was attributed to an inflammatory response evoked by the EMLA ointment base, rather than EMLA itself, since only saline was used as the control. Most in vivo studies assessed LA effect over a short term only: 7 for 1 week or less, 5 for 2 to 3 weeks, and 1 for 6 weeks.…”

Anesthesia drugs, immunity, and long-term outcome

“…Importantly, local anesthetic-induced reductions in leukocyte activation do not seem to be offset by clinically relevant reductions in microbicidal capacity [44,45]. However, two reports caution that local anesthetics may increase the risk of preexisting bacterial infections [45,46]. These studies forecast a broader role for local anesthetics in perioperative management and stimulate interest to define their impact on the incidence of postoperative outcome -short and long-term -for various inflammatory disease states.…”

“…inflammatory bowel disease) [41][42][43]. Importantly, local anesthetic-induced reductions in leukocyte activation do not seem to be offset by clinically relevant reductions in microbicidal capacity [44,45]. However, two reports caution that local anesthetics may increase the risk of preexisting bacterial infections [45,46].…”

Immunological Modifications Induced from Products Used during the Perioperative Period

“…Animal models have shown that local anesthetics may counteract leukocyte adherence and transmigration, edema, and tissue damage by reducing leukocyte integrins (CD II b-CD 18) expression, reactive oxygen metabolites production, and release of chemotactic and pro inflammatory substances, including LTB4, interleukin-I a, and histamine. Although these effects of local anesthetics on phagocyte function and recruitment do not seem to be associated with a clinically relevant impairment in antimicrobial host immune responses, some concerns have been raised from studies reporting an increased risk of preexisting bacterial infections in a few patients (75).…”