Does EMLA reduce the discomfort associated with local-anaesthetic infiltration?

The effectiveness of EMLA cream in relieving the discomfort associated with percutaneous infiltration of lignocaine was assessed in a double-blind, placebo-controlled study. Patients undergoing minor skin surgery were divided into two groups, according to the number of lesions requiring surgery. The first group had a single lesion and were randomized to apply either EMLA or placebo cream 1 h prior to infiltration, whilst the second group received EMLA to one and placebo to the other of two lesions treated at the same clinic attendance. In neither group was there a clinically useful reduction of discomfort, probably due to inadequate dermal anaesthesia, and we would not, therefore, recommend the routine use of EMLA for this purpose. The most recent evidence suggests that a 2-h application time may give more effective dermal anaesthesia, but this would probably limit its use to occasional problematical cases.