psd-502 and Erythema

The aim of this study was to compare the efficacy of topical piroxicam and EMLA cream on pain control and subsequent inflammation in neodymium:yttrium-aluminum-garnet (Nd:YAG) 1,064 nm laser hair removal in female volunteers. Fifty female volunteers were enrolled in this prospective, randomized, double-blind, clinical study over a 6-month period. Patients were randomly assigned to receive topical piroxicam as group Piroxicam or EMLA cream as group EMLA. Topical analgesics were applied to the treatment sites for 60 min. The pain scores [on a visual analog scale (VAS)] and side effects were recorded before the hair removal, during the hair removal, at the end of the hair removal, and 1 h, 2 h and 24 h after the hair removal. Patients' characteristics and the treatment settings of the Nd:YAG 1,064 nm laser were similar in the two groups. The pain scores (VAS) were similar, and satisfaction was high in both groups after the hair removal. The number of blanching and erythema episodes were significantly higher in group E than in group P (P < 0.001). Inflammatory side effects were less frequent in group P than in group E after the procedure (P < 0.001). This study showed that topical piroxicam and EMLA provided adequate and similar pain relief after Nd:YAG 1,064 nm laser hair removal in female volunteers. Topical piroxicam was associated with fewer inflammatory side effects than was EMLA cream, because of its anti-inflammatory effect after the procedure.

Topics: Administration, Topical; Adolescent; Adult; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Dermatitis; Double-Blind Method; Erythema; Female; Hair Removal; Humans; Lasers, Solid-State; Lidocaine; Lidocaine, Prilocaine Drug Combination; Low-Level Light Therapy; Pain; Piroxicam; Prilocaine; Prospective Studies; Young Adult

To examine the efficacy and safety of a new topical anesthetic containing a disinfection ingredient (LidoDin cream) in reducing the pain associated with venipuncture by comparing it with the proven eutectic mixture of lidocaine 2.5% and prilocaine 2.5% (EMLA cream).. A single-blind, randomized, controlled trial was conducted on a study population consisting of a convenience sample of patients aged 12 to 16 years who presented at our Emergency Department between November 2007 and April 2008. The Visual Analog Scale (VAS) was used for pain assessment. Before the study, the bactericidal effect of the LidoDin cream on skin flora was tested.. Twenty patients were enrolled to each arm of the study. Mean patient age was 13.6 years for the LidoDin group and 14.12 years for the EMLA group (P=0.347). Male patients accounted for 55% of the patients in the LidoDin group, compared with 40% in the EMLA group (P=0.527). Skin reaction scores of the LidoDin group for erythema and edema were not statistically different than those of the EMLA group (P=0.73 and P=0.75, respectively). Patient VAS scores and nurse VAS scores of the LidoDin group were not statistically different than those of the EMLA group (P=0.57 and P=0.93, respectively).. This pilot study demonstrated that LidoDin and EMLA seem to be equally safe and effective topical anesthetics for venipuncture. Future studies are planned to determine, if LidoDin reduces the rate of local skin infection in patients treated with multiple daily subcutaneous injections of medications.

Topics: Adolescent; Adult; Anesthetics, Combined; Anesthetics, Local; Child; Disinfectants; Edema; Erythema; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Pain; Pain Measurement; Phlebotomy; Prilocaine

Eutectic mixture of local anaesthetic cream and lidocaine iontophoresis are effective in providing analgesia for peripheral venous cannulation with small gauge cannulae in adults and children. The objective of this study was to compare the analgesic efficacy of the two techniques directly in patients using larger cannulae.. In a double-blind, randomized, controlled study we compared the two techniques directly. Twenty-eight patients had the eutectic mixture of local anaesthetic cream applied to the dorsum of one hand for 60 min followed by sham iontophoresis (group EMLA); the other hand had a sham cream applied for 60 min followed by 10 min of 2 mA iontophoresis with lidocaine 4% and epinephrine 1 in 50,000 (group iontophoresis). Within 5 min of completion of iontophoresis an anaesthetist, unaware of treatment allocation, inserted 18-G venous cannulae into veins of both hands. The patient then scored the amount of pain on cannulation using a 10 point verbal rating scale.. Eight patients were excluded from analysis due to failed cannulation (two group EMLA, two group iontophoresis), intolerable burning sensation from iontophoresis (one), protocol violation (one), and changes in surgical schedule (two). Pain scores were lower for the EMLA treated hand than for the iontophoresis side (median (range) 1 (0-7) vs. 3 (0-6); P = 0.023). Erythema and paraesthesia were common but short lived on the iontophoresis side.. Although lidocaine iontophoresis is effective more quickly than the eutectic mixture of local anaesthetic cream, the superior quality of analgesia produced by the eutectic mixture in this study should be borne in mind if these treatments are used electively.

Topics: Adult; Aged; Analgesia; Anesthetics, Combined; Anesthetics, Local; Catheterization, Peripheral; Double-Blind Method; Erythema; Female; Hand; Humans; Iontophoresis; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Ointments; Pain; Pain Measurement; Paresthesia; Placebos; Prilocaine; Pruritus

Quality aspects of the anesthetic process are reflected in the rate of intraoperative adverse events. The purpose of this report is to illustrate how the quality of the anesthesia process can be analyzed using statistical process control methods, and exemplify how this analysis can be used for quality improvement.. We prospectively recorded anesthesia-related data from all anesthetics for five years. The data included intraoperative adverse events, which were graded into four levels, according to severity. We selected four adverse events, representing important quality and safety aspects, for statistical process control analysis. These were: inadequate regional anesthesia, difficult emergence from general anesthesia, intubation difficulties and drug errors. We analyzed the underlying process using 'p-charts' for statistical process control.. In 65,170 anesthetics we recorded adverse events in 18.3%; mostly of lesser severity. Control charts were used to define statistically the predictable normal variation in problem rate, and then used as a basis for analysis of the selected problems with the following results: Inadequate plexus anesthesia: stable process, but unacceptably high failure rate; Difficult emergence: unstable process, because of quality improvement efforts; Intubation difficulties: stable process, rate acceptable; Medication errors: methodology not suited because of low rate of errors.. By applying statistical process control methods to the analysis of adverse events, we have exemplified how this allows us to determine if a process is stable, whether an intervention is required, and if quality improvement efforts have the desired effect.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents, Non-Steroidal; Catheterization, Peripheral; Edema; Erythema; Female; Gels; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Pain; Pain Measurement; Piroxicam; Prilocaine

To evaluate and compare the analgesic efficacy and anti-inflammatory effects of topical piroxicam gel vs eutectic mixture of local anesthetic (EMLA) cream applied to the peripheral venous cannulation site in adult volunteers.. Piroxicam gel and EMLA cream were randomly applied on the dorsum of the right and left hand of ten volunteers who acted as their own control. A venous cannula was inserted (no iv infusion) and removed after one hour. Pain scores and signs of inflammation were noted at the cannulation site up to 48 hr.. Pain scores with piroxicam gel were higher on cannulation and on advancement of the cannula (P < 0.05). Thereafter, pain scores were significantly higher with EMLA (P < 0.05). Blanching was present at all the peripheral venous sites treated with EMLA cream. Signs of inflammation (erythema, edema) were not more frequent with EMLA than with piroxicam (P > 0.05). Induration was more frequent with EMLA at six hours.. In volunteers EMLA cream is associated with less pain on cannulation and cannula advancement compared to piroxicam gel. Topical application of piroxicam gel before peripheral venous cannulation alleviates pain and, possibly, inflammation in the period subsequent to cannulation itself.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents, Non-Steroidal; Catheterization, Peripheral; Edema; Erythema; Female; Gels; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Pain; Pain Measurement; Piroxicam; Prilocaine

To evaluate the anesthetic efficacy of EMLA cream for alleviating pain associated with puncture and pressure in areas where venous catheters are normally inserted.. We performed a prospective, double blind study in 38 volunteers between 25 and 36 years of age, after obtaining informed consent. A 1.5 g dose of EMLA cream was applied to three sites on each patient: the back of the hand, the antecubital fossa and the side of the neck. Placebo cream with similar characteristics was applied to contralateral sites. Pain was evaluated on a visual analog scale (VAS, 0-10). Tactile sensitivity was assessed on a four-point scale (0 = no sensation; 1 = slight sensation; 2 = moderate, and 3 = strong). An analysis of variance study was performed to compare baseline scores to results over time, and placebo results to EMLA scores for each test site.. The assessment of response to puncture and pressure gradually decreased over time for the sites where EMLA cream was applied, but not for the areas where placebo was applied.. The efficacy of EMLA cream varies demonstrably depending on type of stimulus, site of application and time since application.

Topics: Adult; Anesthetics, Combined; Anesthetics, Local; Double-Blind Method; Elbow; Emulsions; Erythema; Female; Hand; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Neck; Needles; Ointments; Organ Specificity; Pain; Prilocaine; Proprioception; Prospective Studies; Pruritus; Punctures; Time Factors

Local anesthetics inhibit edema and improve circulation in experimental burns. We evaluated the effect of topical local anesthetics on human skin burns in volunteers using computerized color analysis that allowed repeated noninvasive quantitative measurements. A standardized partial-thickness burn (1 cm2) was induced in one forearm of 10 healthy volunteers and in the opposite forearm a week later. The burned areas were treated with lidocaine/prilocaine cream (EMLA; Astra, Sweden) or a placebo cream for 1 h. The experimental skin area was photographed before and 1, 2, 4, and 12 h postburn. Digitized images were evaluated using normalized red-green-blue and Hue-Saturation-Intensity. Differences in erythema between skin treated with EMLA and placebo were not significant during the first 4 h postburn. However, 12 h postburn, a pronounced decrease in the degree of erythema was observed in EMLA-treated skin compared with placebo-treated skin. We conclude that topical local anesthetics administered for 1 h postburn significantly reduces the duration of erythema after a mild thermal injury, which suggests a potential use in clinical practice in the treatment of minor skin burns.. Burn injury constitutes a serious type of tissue damage that activates inflammatory mechanisms, often causing pain, disfiguration, or malfunction. We treated burns using an anesthetic cream and demonstrated a reduction in burn-induced inflammation by using computer-based color image analysis.

Topics: Administration, Topical; Adult; Anesthetics, Combined; Anesthetics, Local; Burns; Erythema; Humans; Image Processing, Computer-Assisted; Lidocaine; Lidocaine, Prilocaine Drug Combination; Ointments; Prilocaine

We have evaluated the efficacy and safety of a preparation of 4% amethocaine gel in alleviating the pain of venous cannulation in children. In an initial open study of 148 children, clinically acceptable anaesthesia was achieved in 92% of cases. The preparation was then compared with 5% EMLA cream in a single-blind study in 94 patients using an application time of 40 min. We found clinically acceptable conditions in 85% of patients receiving amethocaine gel compared with 66% in the EMLA group. There were no significant adverse effects noted in each group, although 37% of those children treated with amethocaine gel showed localized erythema at the application site. The results suggest that amethocaine gel has greater efficacy and a faster onset time than EMLA cream when used for this purpose in children.

Topics: Administration, Cutaneous; Anesthetics, Local; Catheterization, Peripheral; Child; Child, Preschool; Drug Combinations; Erythema; Female; Gels; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Pain; Prilocaine; Single-Blind Method; Tetracaine

EMLA cream is a topical formulation based upon the eutectic mixture of lidocaine and prilocaine and is used in clinical settings to produce local analgesia after application under occlusive dressing. A blanching reaction has been reported to occur locally after application, but it is not clear whether this reaction is caused by the anesthetic mixture, by the vehicle or the occlusion. We studied this blanching reaction in 50 healthy volunteers in a double-blind randomized assay: EMLA versus placebo, under occlusive dressing for 1 h, each subject being his own control. We found 33 cases (66%) of blanching after application of EMLA cream versus 3 cases (6%) after placebo, this difference being highly significant. Blanching was observed without delay, after removal of the dressing, and was very transient, disappearing in less than 3 h in all cases. We thus conclude that the blanching reaction is (1) frequent but very transient, and (2) determined by the anesthetic mixture included in EMLA cream and not by the vehicle alone, nor by the occlusion, since it is not found with the placebo. The precise mechanism of this reaction is unknown.

Topics: Administration, Cutaneous; Anesthetics, Local; Double-Blind Method; Drug Combinations; Erythema; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Occlusive Dressings; Prilocaine; Random Allocation; Skin Pigmentation

EMLA cream is a local anesthetic. The pharmacokinetics and dermal effects of a topical anesthetic formulation has not been evaluated in healthy Chinese volunteers.. The Pharmacokinetics of the lidocaine/prilocaine test (T) or reference (R, EMLA) cream were evaluated in a fasting, single-dose, two-period crossover bioequivalent study conducted in 40 healthy Chinese volunteers. Meanwhile, the dermal effects including blanching, erythema, temperature sensation, edema, and skin rash were also evaluated during the study.. The method described a model for investigations of pharmacokinetics and pharmacodynamics of topical lidocaine/prilocaine cream. Except the plasma drug level indicator, these pharmacodynamics data should also be evaluated in the anesthetic transdermal pharmacokinetics study.. CTR20211544; registered in http://www.chinadrugtrials.org.cn/ at September 2021.

Topics: Anesthetics, Local; Drug Combinations; East Asian People; Erythema; Healthy Volunteers; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Prilocaine

The Eutectic Mixture of Local Anesthetics (EMLA cream) is a topical anesthetic used for providing pain relief in patients undergoing superficial surgical procedures. Cutaneous side-effects have been reported rarely.. We present a case of irritant contact dermatitis induced by EMLA cream in a 6-year-old boy with Wiskott-Aldrich syndrome. Our patient showed clinically a well circumscribed patch corresponding to the site of application of the topical anesthetic. Histopathology showed confluent necrosis of keratinocytes in the upper epidermis, a mixed inflammatory infiltrate with priminent neutrophils in the upper dermis, and focal signs of interface changes including basal cell vacuolization and subepidermal cleft formation.. Graft-vs.-host-disease (GVHD), necrolytic migratory erythema, dermatitis enteropathica and pellagra should be considered in the histopathologic differential diagnosis of acute contact dermatitis caused by EMLA.

Topics: Acrodermatitis; Administration, Topical; Anesthetics, Local; Child; Dermatitis, Contact; Diagnosis, Differential; Drug Eruptions; Erythema; Graft vs Host Disease; Humans; Irritants; Keratinocytes; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Necrosis; Pellagra; Prilocaine

Facial rejuvenation is a popular procedure to temporarily mask the effects of aging. Most patients desiring this treatment are younger and want improvement without any down time. This study was conducted to evaluate the use of Er:YAG laser as a facial rejuvenation tool.. The full faces of 18 volunteers were treated with an Er:YAG laser using a fluence of either 5 or 10 J/cm2. All volunteers applied EMLA cream (lidocaine 2.5% and prilocaine 2.5%) two hours before the procedure and were treated with a single pass using a pulse duration of about 300 microseconds. Follow-up visits were made in order to evaluate the degree of discomfort, erythema, swelling and improvement in skin aging. Skin biopsy was performed in one volunteer before and two hours after EMLA application, although preceding laser treatment.. Most volunteers experienced moderate discomfort during the treatment. There was mild to moderate erythema and mild swelling. The improvement in general skin appearance, actinic bronzing and photo-damage was mild to moderate. The microscopic evaluation of pre-laser treated skin two hours after EMLA application was suggestive of increased water content in the dermis.. The Er:YAG laser is an effective and safe tool for facial rejuvenation. With a superficial treatment, resolution of intense erythema is fairly rapid, averaging two to three days. The improvement, however, is mild compared to full laser skin resurfacing (LSR).

Topics: Adult; Aged; Anesthetics, Local; Erbium; Erythema; Female; Humans; Laser Therapy; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Middle Aged; Prilocaine; Rhytidoplasty; Skin Aging; Treatment Outcome

Topics: Administration, Topical; Anesthetics, Local; Erythema; Humans; Infant; Lidocaine; Lidocaine, Prilocaine Drug Combination; Polyurethanes; Prilocaine; Time Factors

We investigated vascular responses after cutaneous application of EMLA cream (a eutectic mixture of lignocaine and prilocaine) by skin reflectance spectroscopy and laser Doppler blood flowmetry. In healthy subjects, EMLA cream produced a biphasic vascular response with an initial vasoconstriction, maximal after 1.5 h of application. After prolonged application (greater than 3 h, vasodilatation occurred, presumably because of a smooth muscle relaxant effect of the analgesics. Vasoconstriction was also observed initially with two non-EMLA creams applied under occlusion, whereas the occlusive plastic film alone did not alter the vascular state. Thus late vasodilatation was unique to EMLA cream.

Topics: Adult; Analgesia; Anesthetics, Local; Drug Combinations; Drug Eruptions; Erythema; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Prilocaine; Regional Blood Flow; Skin; Time Factors; Vasoconstriction; Vasodilation