Topical Anesthetics Update: EMLA and Beyond

Friedman, Paul M.; Mafong, Erick A.; Friedman, Edward S.; Geronemus, Roy G.

doi:10.1046/j.1524-4725.2001.01855.x

Cited by 130 publications

(137 citation statements)

References 48 publications

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“…ELA-max is superior to tetracaine and betacaine-LA at 60 minutes, while EMLA ® is superior to betacaine-LA at 60 minutes, which is in partial agreement with our prediction. The relative potency after removal is obtained from the mean pain scores 30 minutes after removal of the topical anaesthetics [29,30]. ELA-max and EMLA ® are superior to tetracaine and betacaine-LA 30 minutes after the 60-minute application period, which is in partial agreement with our prediction.…”

Section: Calculation Results and Discussionsupporting

confidence: 80%

“…The predictions have been compared with experimental results [29,30]. The relative potency is obtained from the mean pain scores after application of topical anaesthetics for 60 minutes [29,30]. ELA-max is superior to tetracaine and betacaine-LA at 60 minutes, while EMLA ® is superior to betacaine-LA at 60 minutes, which is in partial agreement with our prediction.…”

Section: Calculation Results and Discussionsupporting

confidence: 65%

“…the eutectic mixture of local anaesthetics (EMLA ® , lidocaine-prilocaine 2.5/2.5% w [28]). However, mixtures of dissimilar anaesthetics are also used, e.g., betacaine-LA (lidocaine-prilocaine-dibucaine) [29] and S-caine (1:1 lidocaine-tetracaine eutectic mixture) [30]. The predictions for topical anaesthetics and ice, both not included in the models, are included in Table 3.…”

Section: Calculation Results and Discussionmentioning

confidence: 99%

“…The predictions for topical anaesthetics and ice, both not included in the models, are included in Table 3. The predictions have been compared with experimental results [29,30]. The relative potency is obtained from the mean pain scores after application of topical anaesthetics for 60 minutes [29,30].…”

Section: Calculation Results and Discussionmentioning

confidence: 99%

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Periodic Classification of Local Anaesthetics (Procaine Analogues)

Torrens

Castellano

2006

IJMS

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Algorithms for classification are proposed based on criteria (information entropy and its production). The feasibility of replacing a given anaesthetic by similar ones in the composition of a complex drug is studied. Some local anaesthetics currently in use are classified using characteristic chemical properties of different portions of their molecules. Many classification algorithms are based on information entropy. When applying these procedures to sets of moderate size, an excessive number of results appear compatible with data, and this number suffers a combinatorial explosion. However, after the equipartition conjecture, one has a selection criterion between different variants resulting from classification between hierarchical trees. According to this conjecture, for a given charge or duty, the best configuration of a flowsheet is the one in which the entropy production is most uniformly distributed. Information entropy and principal component analyses agree. The periodic law of anaesthetics has not the rank of the laws of physics: (1) the properties of anaesthetics are not repeated; (2) the order relationships are repeated with exceptions. The proposed statement is: The relationships that any anaesthetic p has with its neighbour p + 1 are approximately repeated for each period.

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Section: Calculation Results and Discussionsupporting

confidence: 80%

Section: Calculation Results and Discussionsupporting

confidence: 65%

Section: Calculation Results and Discussionmentioning

confidence: 99%

Section: Calculation Results and Discussionmentioning

confidence: 99%

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Periodic Classification of Local Anaesthetics (Procaine Analogues)

Torrens

Castellano

2006

IJMS

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“…EMLA cream has been widely used in different procedures (Barcohana et al, 2003;Chen & Cunningham, 2001;Larijani et al, 2000;McMillan et al, 2000;Sohmer et al, 2003) and its efficacy and safety have been proven in different clinical trials (Friedman, Mafong, Friedman, & Geronemus, 2001), but has rarely been used in reducing patients' pain during EGD. Fanurik et al have also established the efficacy of combination of distraction techniques with EMLA cream on children's distress during and after IV insertion (Fanurik, Koh, & Schmitz, 2000).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Eutectic Mixture of Local Anesthesia Cream (EMLA) on Satisfaction, Pain, and Nausea/Vomiting of Patients Undergoing Gastro-intestinal Endoscopy-A Randomized Clinical Trial Comparing EMLA Cream and Gel, Lidocaine Gel and Spray, and Placebo

Nasiri¹,

Ahmadi²,

Ganji³

2016

GJHS

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Background and objectives: Esophagogastroduodenoscopy is a valuable diagnostic method for the treatment of various diseases that has found a wonderful application in recent years. Yet, controlling patients' pain and nausea is a fundamental factor to increase patient satisfaction, reduce patients' discomfort, and increase the patient's cooperation. Therefore, this study aimed to assess the efficacy of Eutectic Mixture of Local Anesthesia (EMLA) cream and gel, as a topical pharyngeal anesthetic on patients' pharyngeal pain, nausea/vomiting, and satisfaction, in comparison with lidocaine gel and spray and placebo.Methods: This double-blind randomized clinical trial was conducted to assess patient satisfaction, nausea/vomiting, throat and pharyngeal pain during and after endoscopy by different methods of local anesthesia. Thus, 150 patients were randomly divided into 5 groups of 30 receiving placebo, lidocaine gel, lidocaine spray, EMLA gel and cream 5 to 10 minutes before endoscopy. Then patient satisfaction (measured by GHAA-9 questionnaire), pain or discomfort in the throat, and nausea/vomiting were evaluated half an hour after endoscopy.Results: Patient satisfaction score was not statistically different between the test groups (P>0.05), but the throat pain and discomfort and nausea/vomiting during and after endoscopy was statistically different between groups (P<0.05) and the lowest nausea/vomiting was in the group using EMLA cream.Conclusion: Different methods of throat anesthesia had no significant difference on patient satisfaction but EMLA cream and gel caused less nausea/vomiting than lidocaine gel or spray during and after endoscopy.

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