The effect of a eutectic mixture of local anesthetic cream on wrist pain during transradial coronary procedures.

Abstract

OBJECTIVE:

We sought to evaluate the effects and optimal application time of a eutectic mixture of local anesthetic cream (EMLA-C) in relieving wrist pain during transradial coronary procedures (TRCP).

METHODS:

The Phase I study enrolled 147 patients to evaluate the efficacy and safety of the EMLA-C during TRCP. The Phase II study was designed to evaluate the optimal preprocedure application time frame of EMLA-C for wrist pain reduction in 400 patients. The EMLA or placebo cream was applied at the puncture site from 2 to 4 hours before the procedure in Phase I, and randomized to 5 time groups according to the time of drug application in Phase II. We evaluated wrist pain by the visual analogue scale (VAS) or verbal rating scale (VRS-4), and evaluated complications as well.

RESULTS:

EMLA-C demonstrated greater pain relief by VAS (control: 49+/-24, EMLA: 19+/-22; p = 0.001) and VRS-4 (control: 2.3+/-0.5, EMLA: 1.5+/-0.6; p = 0.001), and there was a negative correlation (r = -0.476; p = 0.001) between VAS and the preprocedure application time of EMLA-C. In Phase II, there was a significant difference in pain levels between the control and 1- to 2-hour groups by VAS (control: 49+/-29, EMLA1-2 hours: 32+/-24; p = 0.001) and VRS-4 (control: 2.4+/-0.6, EMLA1-2 hours: 1.9+/-0.6; p = 0.001). Drug-induced local erythema frequently occurred in the 3- to 4-hour group (6.6%) and >4 hours group (11.9%).

CONCLUSIONS:

EMLA-C can be effective in reducing wrist pain during TRCP without any significant drug-related complications when the application time is 1 to 3 hours before the procedure.

• Authors: Jang-Young Kim, Junghan Yoon, Byung-Su Yoo, Seung-Hwan Lee, Kyung-Hoon Choe
• Journal: The Journal of invasive cardiology (J Invasive Cardiol) Vol. 19 Issue 1 Pg. 6-9 (Jan 2007) ISSN: 1557-2501 [Electronic] United States
• PMID: 17297176 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article)

Chemical References

• Drug Combinations
• Lidocaine, Prilocaine Drug Combination
• Ointments
• Prilocaine
• Lidocaine

Topics

• Aged
• Analysis of Variance
• Anesthesia, Local (methods)
• Cardiac Catheterization (methods)
• Case-Control Studies
• Catheterization, Peripheral (adverse effects)
• Coronary Angiography (methods)
• Coronary Disease (diagnostic imaging, therapy)
• Drug Combinations
• Female
• Humans
• Lidocaine (administration & dosage)
• Lidocaine, Prilocaine Drug Combination
• Male
• Middle Aged
• Ointments
• Pain (etiology, prevention & control)
• Pain Measurement
• Patient Satisfaction
• Prilocaine (administration & dosage)
• Probability
• Radial Artery (drug effects)
• Reference Values