Lidocaine-prilocaine cream (EMLA Cream) as a topical anaesthetic for the cleansing of leg ulcers. The effect of length of application time.

Pain prevents the effective cleansing of many leg ulcers. Pain relief during debridement has been reported after topical anaesthesia with EMLA cream. The purpose of this study was to assess and compare the pain intensity during debridement after different lengths of application time of EMLA. Fifty-nine patients, stratified for leg ulcer type, were randomised to 10, 20 or 60 minutes treatment with EMLA prior to debridement. The pain was rated by each patient on a 100-mm visual analogue scale (VAS). Pain intensity during debridement decreased significantly with increasing duration of EMLA application (p = 0.001). The median values of the VAS pain scores were 41, 20 and 8 in the 10-, 20- and 60- minute groups respectively. A minimum of 20 minutes application time gives substantial pain relief in the majority of patients.