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.

OBJECTIVE: The study was undertaken to evaluate the efficacy of eutectic lidocaine/prilocaine (EMLA) cream for decreasing pain during local anaesthetic infiltration for outpatient haemorrhoidectomy.

METHODS: Ninety-eight patients were randomly assigned either to receive EMLA or placebo. The creams were applied 45 minutes prior to injection of a lidocaine/bupivacaine mixture using a diamond-shaped perianal block. All participants were blinded to the specific medication received. They were asked to rate pain and levels of acceptability using a pre-validated pain scale and questionnaire.

RESULTS: There were 49 patients in each group. The baseline characteristics between the two groups were similar. Forty patients (82%) in the EMLA group and 42 patients (86%) in the placebo group reported only mild pain during injection and infiltration of the lidocaine/bupivacaine mixture. The mean rank pain scores were 49.11 and 48.89, respectively (p = 0.886, not significant).

CONCLUSION: 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.