Double-blind, Randomized, Placebo-controlled Trial to Determine the Efficacy of Eutectic Lidocaine/Prilocaine (EMLA) Cream for Decreasing Pain During Local Anaesthetic Infiltration for Out-patient Haemorrhoidectomy

Roxas, Manuel Francisco; Talip, Babie Normita F.; Crisostomo, Armando C.

doi:10.1016/s1015-9584(09)60211-6

Cited by 16 publications

(9 citation statements)

References 9 publications

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“…A study using eutectic lignocaine/prilocaine (EMLA) before injection for hemorrhoidectomy did not improve any of these symptoms. While outpatient hemorrhoidectomy under local anesthesia was generally well tolerated, there was no statistically significant difference between EMLA cream and placebo for decreasing pain during anesthetic infiltration [8].…”

Section: Discussionmentioning

confidence: 85%

How to do Open Hemorrhoidectomy Under Local Anesthesia and its Comparison with Spinal Anesthesia

et al. 2012

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50 patients with III/IV degree hemorrhoids and grade II hemorrhoid not responding to conservative treatment were randomized to LA (5 grade II, 15 grade III and 5 grade IV) and SA (7 grade II, 14 grade III and 4 grade IV). Assessment was carried out afterwards in terms of pain scores (using Numerical Rating Scale, NRS at 30 mins, 90 mins, 6 h and 24 h) and post operative analgesia. Secondary outcomes were complications like urinary retention, post operative headache and surgical complications, and overall stay. Median pain scores were comparable in both the treatment groups during the whole study period except at 6 h where significantly higher (p < 0.05) pain scores were noted in spinal anesthesia group. Complications were much higher in Spinal anesthesia [Hypotension (4patients); post operative headache (6patients); urinary retention (9patients)]. Mean time at first bladder evacuation was significantly higher in patients operated under spinal anesthesia [8 h (SA) Vs 1.5 h (LA)]. Average hospital stay was significantly longer in patients operated under spinal anesthesia (p value < 0.001). Local anesthesia is an alternative mode of anesthesia that surgeon can safely carry out by their own. In our study hemorrhoidectomy under local anesthesia was associated with a shorter hospital stay, lower pain scores and lower post operative complications which supports the routine use of local anesthesia for hemorrhoidectomy.

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Section: Discussionmentioning

confidence: 85%

How to do Open Hemorrhoidectomy Under Local Anesthesia and its Comparison with Spinal Anesthesia

et al. 2012

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“…Some adverse comments referred to the pain of needle insertion, burning and a pressure sensation. A study using eutectic lidocaine/prilocaine before injection for haemorrhoidectomy did not improve any of these symptoms84. There is no evidence to support the use of bicarbonate to neutralize the acidity of local anaesthetics.…”

Section: Discussionmentioning

confidence: 96%

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Kushwaha

Hutchings

Davies

et al. 2008

British Journal of Surgery

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Background:Day-care open haemorrhoidectomy under local anaesthesia (LH) may be the most costeffective approach to haemorrhoidectomy. This prospective randomized trial compared outcome after LH from patients' and clinical perspectives with that after day-care open haemorrhoidectomy under general anaesthesia (GH).Methods: Forty-one patients with third-degree haemorrhoids were randomized to LH (19) or GH (22). Patient demographics were comparable. A single haemorrhoid was excised in 15 patients, and two and three haemorrhoids in 13 each. Independent nurse-led assessment and clinical evaluation were carried out for 6 months. Outcome measures were mean and expected pain scores at 30, 60 and 90 min, then daily for 10 days, and satisfaction scores at 10 days, 6 weeks and 6 months. Secondary outcomes were journey time within the day-surgery unit and overall cost.Results: Pain was worse following LH than GH at 90 min after surgery (P = 0·028), but pain scores on reaching home were similar. Maximum pain was experienced on day 3 after LH and on day 6 after GH. From day 1 onwards, daily pain scores were lower in the LH group, and there was a significant difference on day 8 (mean (95 per cent confidence interval) 3·61 (2·74 to 4·48) for LH versus 5·29 (4·12 to 6·45) for GH; P = 0·027). Mean pain over 10 days, expectation and satisfaction scores were similar in the two groups. LH had a shorter journey time and was less expensive than GH.Conclusion: LH has similar tolerance and clinical outcome to GH, and is associated with a shorter journey time and lower cost. Registration number: NCT00503269 (http://www.clinicaltrials.gov).

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“…Blood sampling is a frequent medical procedure, very often considered a stressful experience not only by children but also by some adults. Local anesthetics have been developed and successfully tested in dental care (1), dermatology (2), vaccinations (3–5), and blood sampling (6). However, this kind of drug is expensive, not reimbursed by insurance companies in our country and might therefore not be systematically used in case of blood sampling or immunization, leading to unnecessary suffering.…”

Section: Introductionmentioning

confidence: 99%

Parents’ willingness to pay for diminishing children's pain during blood sampling

Wasserfallen

Currat‐Zweifel

Cheseaux

et al. 2005

Pediatric Anesthesia

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Double-blind, Randomized, Placebo-controlled Trial to Determine the Efficacy of Eutectic Lidocaine/Prilocaine (EMLA) Cream for Decreasing Pain During Local Anaesthetic Infiltration for Out-patient Haemorrhoidectomy

Abstract: While outpatient haemorrhoidectomy under local anaesthesia was generally well tolerated, there was no statistically significant difference between EMLA cream and placebo for decreasing pain during anaesthetic infiltration.

Cited by 16 publications

References 9 publications

How to do Open Hemorrhoidectomy Under Local Anesthesia and its Comparison with Spinal Anesthesia

How to do Open Hemorrhoidectomy Under Local Anesthesia and its Comparison with Spinal Anesthesia

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Parents’ willingness to pay for diminishing children's pain during blood sampling

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