JOURNAL BROWSE
Search
Advanced SearchSearch Tips
Comparative efficacy of 5% EMLA cream and 20% Benzocaine gel during topical anesthesia
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Comparative efficacy of 5% EMLA cream and 20% Benzocaine gel during topical anesthesia
Lee, Dae-Woo; Baik, Byeong-Ju; Kim, Jae-Gon; Yang, Yeon-Mi; So, Yu-Ryeo;
  PDF(new window)
 Abstract
The objective of this study was to determine the effectiveness of topical 5% EMLA cream versus 20% Benzocaine gel in reducing pain from intra oral needle insertion alone as well as injection of anesthetic. The 2 topical anesthetics were tested against each other bilaterally using a randomized, controlled, single blinded, split mouth design. Phase I was conducted to find out the rapidity of onset action of the two agents on anterior/posterior vestibules and anterior/posterior palatal mucosa. Phase II was conducted to evaluate the efficacy of the two topical anaesthetic agents in reducing the pain of intraoral injections. The agents were left in anterior/posterior vestibules and anterior/posterior palatal mucosa for the amount of time recorded in phase I. Subjects recorded pain on a 100-mm modified visual analog scale(VAS). A pulse oximeter was used to recorded the preoperative and postoperative pulse rates. In phase I of the study, two topical agents showed the longer onset of action at anterior part and vestibules than posterior part and palatal mucosa. EMLA cream showed the rapidest onset of action compared to benzocaine gel except on anterior palatal mucosa. In phase II of the study, the VAS grading of the pain for anesthetic administration showed EMLA cream was significantly(P<.05) better in elimination or reducing the pain on the anterior/posterior palatal mucosa. In conclusion, EMLA cream showed the rapidest onset of action compared to benzocaine gel except on anterior palatal mucosa. EMLA cream was found to be superior to Benzocaine gel with regards to pain reduction for anesthetic administration especially on anterior and posterior palatal mucosa.
 Keywords
Topical anesthesia;EMLA cream;Benzocaine gel;Pain control;
 Language
Korean
 Cited by
 References
1.
Baghdadi DZ : Evaluation of electronic dental anaesthesia in children. Oral Surg Oral Med Oral Pathol Oral RadiolEndod, 88:418-423, 1999. crossref(new window)

2.
Asarch T, Allen K, Petersen B, Beiraghi S : Efficacy of a computerized local anesthesia device in pediatric dentistry. Pediatr Dent, 21:421-424, 1999.

3.
김희진, 고승백, 홍성수 등. : 소아에서 EMLA 크림을 이 용한 도포마취: 증례보고. 대한소아치과학회지, 29(1): 69-75, 2002.

4.
Campbell AH, Stasse JA, Lord GH, Nilson JE : In vivo evaluation of local anaesthetic applied topically. JPharm-Sci, 57:2045-2048, 1968. crossref(new window)

5.
김규식, 김명진 : 치과국소마취학. 지성출판사, 1991.

6.
Vickers ER, Punnia Moorthy A : A clinical evaluation of three topical anaesthetic agents. Aust Dent J, 37(4):266-270, 1992. crossref(new window)

7.
Cavino BG : Pharmacology of local anaesthetic agents. BrJAnaest, 58:701, 1986.

8.
이재춘, 김대업, 이광희 외 : 분사식 주사기를 이용한 소아 환자의 국소마취. 대한소아치과학회지, 28(4):633-637, 2001.

9.
Tulga F, Mutlu Z : Four types of topical anaesthetic agents: evaluation of clinical effectiveness. J Clin Pediatr Dent, 23(3):217-220, 1999.

10.
Gill C, Orr D : A double-blinded crossover comparison of topical anesthetics. JADA, 98:213-214, 1979.

11.
Yaacob H, Noor G, and Malek S : The pharmacological effect of xylocaine topical anesthetic-A comparison with a placebo. Singapore Dent J, 6:55-57, 1981.

12.
Svensson P, Peterson JK : Anesthetic effect of EMLA occluded with orahesive oral bandages an oral mucosa, A placebo controlled study. Anesth Prog, 39(3):79-82, 1992.

13.
Juhlin L, Evers H, Broberg F : A lidocaine-prilocaine cream for superficial skin surgery and painful lesions. Acta Derm Venereol, 60:544-546, 1980.

14.
Holst A, Evers H : Experimental studies of new topical anaesthetics on the oral mucosa. Swed Dent J, 9:185-191, 1985.

15.
Haasio J, Jokinen T, Numminen P, et al. : Topical anaesthesia of gingival mucosa by 5% eutectic mixture of lignocaine and prilocaine or by 10% lignocaine spray. Br J Oral Maxillofac Surg, 28:99-101, 1990. crossref(new window)

16.
Rosivack RG, Koenigsberg SR, Maxwell KC : An analysis of the effectiveness of two topical anaesthetics. Anesth Prog, 37(6):290-292, 1990.

17.
Pere P, Lizuka T, Rosenberg PH, et al. : Topical application of 5% eutectic mixture of lignocaine and prilocaine (EMLA) before removal of arch bars. Br J Oral Maxillofac Surg, 30(3):153-6, 1992. crossref(new window)

18.
Vickers ER, Punnia Moorthy A : Pulpal anaesthesia from an application of a eutectic topical anesthetic. Quintessence lnt, 24(8):547-551, 1993.

19.
Meechan JG, Donaldson D : The intra oral use of EMLA cream in children: A clinical investigation. ASDC J Dent Child, 61(4):260-262, 1994.

20.
Svensson P, Petersen JK. Svensson H : Efficacy of a topical anaesthetic on pain and unpleasentness during scaling gingival pockets. Anesth Prog, 41(2):35-39, 1994.

21.
Meechan JG, Winter RA : A comparison of topical anaesthesia and electronic nerve stimulation for reducing the pain of intra oral injections. Br Dent J, 181(9):333-335, 1996. crossref(new window)

22.
Meechan JG, Thomason JM : A comparison of 2 topical anaesthetics on the discomfort of intraligamentary injections, A double-blind, split mouth volunteer clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 87:362-365, 1999. crossref(new window)

23.
Roghani S, Duperon DF, Barcohana N : Evaluating the efficacy of commonly used topical anaesthetics. PediatrDent, 21(3):197-200, 1999.

24.
Nayak R, Sudha P : Evaluation of three topical anaesthetic agents against pain: a clinical study. Indian J Dent Res, 17(4):155-60, 2006. crossref(new window)

25.
Huskinson EC : Measurement of pain. Lancet, 1127-1131, 1974.

26.
Krane JE, Tyler DC : Post operative pain management in children. Anaesth Clin North America, 7(1):159-160, 1989.

27.
Huskinson EC : Visual analogue scales. In Melzack R: Pain measurement and assessment. New York Raven, Press; 33-37, 1983.

28.
Wright GZ, Marti R, Weinberger SJ : The effectiveness of infiltration anaesthesia in the mandibular primary molar region. Pediatr Dent, 13:278-283, 1991.

29.
Meechan JG, Webery RR : Oral Surgery for children: 2: Anaesthesia and sedation, Dental Update 206-212, 1993.

30.
American Dental Association Council On Dental Therapeutics : Accepted dental therapeutics, Chicago 1984, The American Dental Association sited in Stanley F. Malamed: Hand book of local Anaesthesia, (4th Ed), Mosby; 304, 1997.

31.
Book A, Fehlandt C, Krija M, et al. : Methemoglobin intoxication by prilocaine in EMLA. Accidental intoxication of an infant with scald injuries. Anaesthesist. 2009 Apr;58(4):370-4. German. crossref(new window)

32.
Chung NY, Batra R, Itzkevitch M, et al. : Severe methemoglobinemia linked to gel-type topical benzocaine use: a case report. J Emerg Med. 2010 Jun;38(5):601-6. Epub. 2008 Dec 20. crossref(new window)

33.
Balicer RD, Kitai E : Methemoglobinemia caused by topical teething preparation: a case report. Scientific World Journal, Jul 15;4:517-20, 2004. crossref(new window)

34.
Parker JF, Vats A, Bauer G. : EMLA toxicity after application for allergy skin testing. Pediatrics, 113(2): 410-1, 2004 Feb. crossref(new window)

35.
Raso SM, Fernandez JB, Beobide EA, et al. : Methemoglobinemia and CNS toxicity after topical application of EMLA to a 4-year-old girl with molluscum contagiosum. Pediatr Dermatol, 23(6):592-3, 2006 Nov-Dec. crossref(new window)

36.
Bagesund M, Tabrizi P. : Lidocaine 20% patch vs lidocaine 5% gel for topical anaesthesia of oral mucosa. Int J Paediatr Dent, 18(6):452-60, Epub 2008 Mar 12. crossref(new window)