미숙아에서 경구 포도당액, EMLA^(R)크림, 노리개 젖꼭지(pacifiers)의 통증 감소 효과에 대한 비교

윤영훈,노영일,김은영,박상기 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.2

Background and Objectives : We compared the pain reducing effect of orally administered glucose with that of EMLA cream and pacifiers during venipuncture in preterm infants. Material and Method : Twenty two preterm infants were included for this study. We performed four methods in al1 preterm infants. First, control group, second, received EMLA cream on the skin, third, received 30% glucose orally administered, and fourth, received pacifiers. Symptoms associated with pain at venipuncture were measured with the Premature Infants Pain Profile (PIPP) scale. Result : Among the subjects, 14 (63.6%) was male, 8 (36.4%) was female. The distribution of gestational age was as follows ; gestational age 30~34 was 2, 32333 was 2, 34-35 was 10, 36-37 was 8. The comparison of PIPP score between groups was as follows : control group was 12.73±2.45, EMLA group was 10. 05±3.59, 30% glucose group was 6.45±2.06, pacifiers group was 9.18±2.32 (P<0.001). The percentage of patients with PIPP score above 12 was as follows : control group was 68.5%, EMLA group was 31.8%, 30% glucose group was 0%, pacifiers group was 14.5%. The mean heart rate change between before and after venipuncture was as follows : control group was 22.32±4.09, EMLA group was 31.91±3.53, 30% glucose group was 7.00±4.14, pacifiers group was 9.36±2.15. Conclusion : Our study supports the use of oral glucose, EMLA, and pacifers is the effective intervention at venipuncture in preterm infants. The most effective method was oral glucose. 목 적 : 미숙아에서 포도당의 경구 투여, 국소 마취 크림인 EMLA^(R)와 노리개 젖꼭지의 통증 감소 효과를 비교하고자 본 연구를 시행하였다. 방 법 : 2003년 3월부터 8월까지 조선대학교 병원 신생아실에 입원한 재태연령 37주 미만의 미숙아를 대상으로 4가지 방법으로 통증 감소를 측정하였다. 제 1 군(대조군)은 아무것도 투여하지 않은 군, 제 2군은 EMLA^(R) 크림을 바른 군, 제 3군은 30% 포도당액을 먹인 군, 마지막 제 4군은 노리개 젖꼭지를 물린 군으 로 나누어서 통증을 감소를 비교하였다. 통증의 평가는 PIPP 점수와 최고 심장 박동수의 변화를 측정하였다. 결 과 : 1. PIPP 접수 비교 대상아이의 PIPP 점수를 보면 대조군 12.73±2.45, EMLA^(R) 크림군 10.05±3.59, 30% 포도당군 6.45♀2.06, 노리개 젖꼭지군이 9.18±2.32로 대조군에 비해서 다른 군들이 유의하게 낮았다(모두, P<0.001). 30% 포도당군이 EMLA^(R) 크림군의 PIPP 접수에 비해 유의하게 낮았으며 (P<0.05), 노리개 젖꼭지군의 PIPP 점수에 비해서도 유의하게 낮았다(P<0.05). 2. 통증을 느끼는 PIPP 6점 이상 비율의 비교 통증을 느끼는 PIPP 6점 이상의 비율을 비교하면 대조군 100% (22명), EMLA^(R) 크림군 86% (19명), 30% 포도당군 50% (11명), 노리개 젖꼭지군은 90% (20명) 으로 30% 포도당군에서 가장 낮았다. 3. 심한 통증을 느끼는 PIPP 12점 이상 비율 비교 심한 통증을 느끼는 PIPP 12점 이상의 비율을 비교하면 대조군 68.6% (15명), EMLA^(R) 크림군 31.8% (7명), 30% 포도당군 0% (0명), 노리개 젖꼭지군은 14.5% (1명) 으로 30% 포도당군이 가장 낮았다. 4. 최고 심장 박동수의 변화 비교 최고 심장 박동수의 증가를 비교하면 대조군 22.32±4.09, EMLA^(R) 크림군 13.91±3.53, 30% 포도당군 7.00±4.14, 노리개 젖꼭지군이 9.36±2.15로 대조군에 비해서 다른 군들이 유의하게 낮은 증가를 보였다(모두, P<0.001). 30% 포도당군의 최고 심장 박동수의 증가가 EMLA^(R) 크림군에 비해 유의하게 낮았으나(P<0.001), 노리개 젖꼭지군과 비교하면 두 군간의 유의한 차이는 없었다(P>0.05). 결 론 : 미숙아에서 통증의 감소에 EMLA^(R) 크림, 포도당액의 경구 투여, 노리개 젖꼭지가 효과가 있었으며, 포도당액의 경구 투여의 경우에는 빠른 시간에 효과가 나타나서, 이용이 용이할 것 같다.

척수 천자시 EMLA도포에 의한 통증 완화 효과

문한구(Han Ku Moon),안준형(Jun Hyung Ahn),박용훈(Yong Hoon Park) 대한소아신경학회 1995 대한소아신경학회지 Vol.2 No.2

배 경 : 신경계 질환의 진단이나 치료시 흔히 사용되는 척수 천자술은 치명적인 합병증이나 후유증이 문제가 될 수도 있으나 드물고, 척수 천자 시술 자체에 수반되는 통증이 더 흔하게 겪는 문제점이다. 저자들은 척수 천자 시술시 연고형 국소 마취제인 EMLA의 통증 완화 효과를 알아 보기 위하여 본 연구를 시행하였다. 방 법 : 1993년 5월부터 7월까지 영남대학병원 소아과에 입원하여 척수 천자술을 시행받은 44명의 환아를 대상으로 EMLA를 사용하거나(EMLA사용군), 가약을 사용(대조군)하여 그들이 느꼈던 통증의 정도를 여러 척도로 비교 관찰하였다. 결 과 : 1) 통증에 대한 환아의 반응(verbal rat-ing)은 “조금 아프다”가 EMLA사용군에서는 34례(100%), 대조군에서는 1례(10%)였고, “꽤 아프다”와 “많이 아프다”는 EMLA군에서는 한 예도 없었으나, 대조군에서는 각각 4례(40%), 2례(20%)였다(p<0.01). 2) McGrath's Face Scale은 EMLA군에서는 D와 E가 각각 10례(29.4%)와 22례(64.7%)였으나, 대조군에서는 F,G와 H가 각각 2례(20%), 4례(40%), 2례(20%)로 대조군에 비해 EMLA사용군에서 통증이 적었다(p<0.01). 3) Oucher Pain Scale 은 EMLA사용군에서는 40점이 28례(82.4%), 60점이 6례(17.6%)였으나, 대조군에서는 50,60,100점이 각각 2례(20%), 1례(10%), 2례(20%)로 EMLA사용군에서는 통증 완화 효과가 더 좋았다(p<0.05). 4) Visual analogue scale은 대조군에서 2,4,6 그리고 7점이 각각 2례(20%)였으며, EMLA군에서는 3,4점이 각각 28례(82.4%), 4례(11.8%)로 EMLA사용군에서 통증 완화효과가 있을 것으로 생각되었으나 p값은 0.14로 통계적으로 유의하지 못했다. 5) EMLA를 부착한 부위의 부작용으로는 가려움이 2례에서, 발적이 1례에서 관찰되었으나 전신적인 부작용은 없었다. 결 론 : 소아에서 신경계 질환의 진단이나 치료를 위해 자주 시행되는 척수 천자 시술 전 국소 마취 연고(EMLA)의 도포는 심각한 부작용의 위험없이 불가피하게 발생되는 척수 천자로 인한 통증을 의미있게 완화시켜 줄 수 있는 한 가지 좋은 방법으로 생각된다. Background : A new topical anesthetic ointment(EMLA:eutectic mixture of local anesthetic) composed of eutectic mixture of prilocaine and lidocaine was studied to evaluate its efficiency in allevaiating pain associated with lumbar punctures in children. Method : Pain intensity was scored by verbal rating. McGrath's pain scale. Oucher face scale and visual analogue scale. Lumbar punctures were performed on 44 cases (34 EMLA treated patients. 10 placebo treated patients) from 5 to 15 years of age. Result : EMLA cream was associated with less pain scores than those with placebo ( verbal rating. McGrath's pain scale: p<0.01 Oucher face scale: p<0.05) except in visual analogue scale(P=0.144). Minor local reactions were reported : itching was observed in 2 children and erythema was in a child following EMLA application. Conclusion : It was concluded that the use of EMLA cream substantially reduces pain caused by lumbar punctures in children and may therefore be offered to such procedures.

신생아의 정맥천자시 통증 감소 효과 : 경구 포도당액, EMLA^Ⓡ 크림 및 노리개 젖꼭지

박상기,김은영,Park, Sang Kee,Kim, Eun Young 대한소아청소년과학회 2006 Clinical and Experimental Pediatrics (CEP) Vol.49 No.4

목 적 : 신생아에서 포도당의 경구 투여, 국소 마취 크림인 $EMLA^{(R)}$와 노리개 젖꼭지의 통증 감소 효과를 비교하고자 하였다. 방 법 : 2003년 3월부터 12월까지 조선대학교병원 신생아실에 입원한 신생아들을 대상으로 4가지 방법으로 통증 감소를 측정하였다. 제 A군(대조군)은 아무것도 투여하지 않은 군, 제 B군은 $EMLA^{(R)}$ 크림을 바른 군, 제 C군은 10% 포도당액을 먹인 군, 제 D군은 30% 포도당액을 먹인 군, 마지막 제 E군은 노리개 젖꼭지를 물린 군으로 나누어서 통증의 감소를 비교하였다. 통증의 평가는 PIPP 점수를 측정하였다. 결 과 : 미숙아와 만삭아 사이에서 평균 PIPP 점수에는 유의한 차이가 없었다. 각 군의 평균 PIPP 점수를 보면 A군 $12.5{\pm}2.5$, B군 $10.1{\pm}2.6$, C군 $9.4{\pm}2.0$, D군 $6.5{\pm}2.1$, E군이 $8.7{\pm}2.3$로 대조군에 비해서 다른 군들이 유의하게 낮았다($EMLA^{(R)}$ 크림군 P<0.05, 그 외 모두, P<0.001). D군의 평균점수가 B, C, E군들의 평균 PIPP 점수에 비해 유의하게 낮았다(각각, P<0.001, P<0.005, P<0.05). 통증을 느끼는 PIPP 6점 이상의 비율을 비교하면 A군 100%, B군 82%, C군 56%, D군 40%, E군은 70%로 D군에서 가장 낮았다. 심한 통증을 느끼는 PIPP 12점 이상의 비율을 비교하면 A군 72%, B군 30%, C군 22%, D군 0%, E군은 14%로 D군이 가장 낮았다. 결 론 : 신생아에서 통증의 감소에 포도당액의 경구 투여, $EMLA^{(R)}$ 크림, 노리개 젖꼭지가 모두 효과가 있었으며, 특히 30% 포도당액의 경구 투여가 가장 효과적이었다. Purpose : We compared the pain reducing effect of orally administered glucose solution with EMLA cream and pacifiers during venipuncture in newborn infants. Methods : Fifty newborn infants(30 prematures) were enrolled in this study. We performed these four pain-reducing methods to all infants in serial order. Group A(control) did not receive any treatment; to group B, EMLA cream was applied on the skin for 1 hour; group C(or D) received 10 percent(or 30 percent) glucose solution orally; group E used pacifiers. Symptoms and signs associated with pain at venipuncture were measured with the Premature Infants Pain Profile(PIPP) scale. Results : There was no significant difference in the PIPP scores between preterm and fullterm infants. The mean PIPP scores of groups were A : $12.5{\pm}2.5$, B : $10.1{\pm}2.6$, C : $9.4{\pm}2.0$, D : $6.5{\pm}2.1$ and E : $8.7{\pm}2.3$; the mean scores of groups B, C, D and E were significantly lower than that of group A(all, P<0.001 except B(P<0.05)), and the mean score of D was significantly lower than those of B, C and E(P<0.001, P<0.005, P<0.05, respectively). The percentages of patients with PIPP scores above 6, which means pain, were A : 100 percent, B : 82 percent, C : 56 percent, D : 40 percent and E : 70 percent. The percentages of patients with PIPP scores above 12, which means severe pain, were A : 72 percent, B : 30 percent, C : 22 percent, D : 0 percent and E : 14 percent; that of group D was clearly lowest. Conclusion : These results support the use of oral glucose solution, EMLA, and pacifiers for pain reduction as effective intervention at venipuncture in newborn infants. The most effective method was a 30 percent oral glucose solution.

CO₂레이저 시술을 위한 신체부위에 따른 적절한 EMLA^(?) 도포 시간에 대한 고찰

이동초,오경재 원광대학교 대학원 2008 論文集 Vol.41 No.-

Background : Topical anesthetics are commonly used to decrease the pain associated with laser or minor surgical procedure. EMLA^?(Euteric Mixture of Local Anesthetics) is the most commonly used topical anesthetic agent prior to procedures. Application duration of 1 hour was usually recommendedfor adequate anesthesia for procedures involving intact skin. Objective : To determine the optimal application duration of EMLA^(?) for adequate cutaneous anesthesia for CO₂ laser procedure according to each part of the body, gender. Methods : Twenty volunteers (14 men, 6 women) between the ages of 22-29 years were participated in study. They had many nevi on their faces, hand dorsum, arm, leg; abdomen and back. The face was divided into four regions including forehead, zygomatic region, cheek and chin. Four skin lesions in every region of each part were selected as experimental regions. Equal amount of EMLA^(?) cream were applied to the total 36 test sites under an impermeable plastic occlusion dressing. One by one each region was stimulated by CO₂ laser every 45, 60, 75, 90, 105 and 120 minutes. Volunteers rated the level of pain experienced during laser treatment on a five-point pam scale (grade 0-4). We defined the shortest time when they become numbed (grade 0) or they had a sense with no pain (grade 1) as optimal anesthetic duration. Result : When stimulated by CO₂ laser, optimal application duration of EMLA^(?) was 56.63, 86.25, 71.25, 73.5, 60, 48.75 minutes for lesion on the face, hand dorsum, arm, leg, abdomen and back. And there's no difference according to sex. Conclusion : For the treatment of CO₂ laser, application duration of EMLA^(?) is approximately 50 minutes for lesion on the back, 60 minutes for lesion on the face, abdomen, 70 minutes for lesion on the arm, leg, 90 minutes for the lesion on the hand dorsum.

임상 ; 미숙아의 경피중심정맥 도관 시 마취 연고가 통증 완화에 미치는 효과

신화진 ( Hwa Jin Shin ),박인숙 ( In Sook Park ),신윤정 ( Youn Jeong Shin ),김승연 ( Seung Yeon Kim ) 대한주산의학회 2011 Perinatology Vol.22 No.4

목적 : 본 연구는 미숙아에게 경피중심정맥 도관술 시 발생되는 치료적 처치의 통증에 국소 마취 연고(EMLA)가 미숙아의 통증을 경감시키는데 효과가 있는지 증명하고자 한다. 방법 : 2010년 대전을지대학병원 신생아 중환자실에 입원한 미숙아를 대상으로 총 정맥 영양법의 장기간 적용이 예상되는 재태기간 36주 미만이고 출생 시 체중 2,000 g 이하의 영아를 대상으로 하였다. 연구 참여에 동의한 미숙아 중 실험군 9명에게는 경피중심정맥 도관 처치 40분전에 EMLA크림을 도포하고 대조군 9명에게는 위약을 도포하였다. 중심정맥 천자 전, 천자 시 15초, 천자 후 30초로 각각 대상자의 모니터상 기록된 심박동수와 산소포화도를 기록하고 대상자의 통증 행동 반응을 삽입 종료 후 2분간 녹화하였다. 결과 : 실험군은 통증 행동 반응의 정도가 유의하게 낮았으며(P=0.005). 경피중심정맥 도관 삽입 종료 후 2분동안 통증행동 반응에서도 낮은 통증 점수를 보였다(P=0.001). 통증점수의 세부 항목별로 보면 행동 상태 반응 점수에서 실험군이 통증 점수가 낮아 통계적으로 유의한 차이가 있었다(P=0.017). 심박동수 증가에서도 실험군이 대조군에 비해 통증점수가 낮았으며 통계적으로 유의한 차이가 있었다(P=0.033). 결론 : 이 연구에서는 연구대상자의 적은 표본 수에도 불구하고 실험군은 경피중심정맥 도관 삽입 시 대조군에 비하여 낮은 통증 정도를 보였다. 저자들은 신생아 중환자실에서 치료적 처치 시 통증 완화를 위해 EMLA 사용을 제안해 보는 바이다. Purpose : The purpose of this study is to prove the effects of topical anesthetics (EMLA) to control pain in preterm infants during invasive procedure (percutaneous central venous catheterization, PCVC). Methods : A total of 18 preterm infants of birth weight <2,000 g and gestational age <36 weeks born at EulJi University Hospital, at Daejeon in 2010 were randomly included in this study. EMLA was applied in nine preterm infants 40 minutes before starting PCVC and placebo was applied in another nine preterm infants. Based on PIPP (preterm infant pain profile), we evaluated their heart rate, oxygen saturation before, 15 seconds during and 30 seconds after procedure. Behavioral responses were also recorded for 2 minutes after procedure. Results : Experimental group showed significantly less behavioral response during procedure ( P=0.005) and 2 min after procedure ( P=0.001). Also, experimental group showed less increase in heart rate ( P=0.033) and reduction of behavioral state ( P=0.017). Conclusion : Despite limitation of small size in this study, experimental group showed lower pain score compared with placebo control group during catheterization. In neonatal care unit (NICU), we recommend the use of topical anesthetics such as EMLA to control pain during invasive procedures.

Topical brimonidine as an effective adjuvant to local anesthetics for post-treatment erythema and pain reduction

( Hyun Jung Kwon ),( Joon Hyuk Suh ),( Kui Young Park ),( Sang Ju Lee ),( Myeung Nam Kim ) 대한피부과학회 2017 대한피부과학회 학술발표대회집 Vol.69 No.2

Background: There are few pharmacologic options to reduce laser-associated post treatment erythema and to extend anesthesia duration. Development of a novel adjuvant agent to topical lidocaine cream is required. Objectives: This study aimed to evaluate the efficacy and safety of a combination of topical brimonidine and EMLA^® as an aid for post treatment erythema and pain. Methods: A total of 15 Korean subjects were randomized to receive a split-face, subject-blind application of a mixture of brimonidine and EMLA^® on one side and only EMLA^® on the other side of the face for anesthesia. After performing 1,550 nm erbium-glass fractionated laser, post-treatment erythema and pain were assessed at four time points: immediately after resurfacing, 30 minutes after, 60 minutes after, and 1 day after. Results: A combination of brimonidine and EMLA^® significantly lowered post treatment erythema until 60 minutes after the laser procedure. Furthermore, 30 and 60 minutes after the procedure, patients reported significantly lower post-procedural pain on the side where the mixture of brimonidine and EMLA^® was applied. Conclusion: Topical brimonidine can be used as an effective adjuvant agent to lidocaine-based topical anesthetics.

LIDOCAINE과 PRILOCAINE을 혼합한 도포 마취제, EMLA크림에 대한 실험 및 임상응용

김용배,박종섭,박병일,이영만,원기정 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.5

EMLA is an oil-in-water emulsion cream, containing 50mg of active substances per ml(25mg lidocaine, 25mg prilocaine). It has been shown to be effective as a topical anesthetic for painful procedure in children and adults, such as venous cannulation, removal of contagious molluscs and split skin grafting. We have tried experimental study in 20 volunteers(male : 12, female : 8) for adequate aplication time, anesthetic depth and duration. The increase in analgesic effect after removal of the cream was studied using different times(30, 60, 90, and 120minutes) for topical EMLA cream application. The pin-prick test was performed at immediately removal of the cream and 30 minutes intervals. We found the most maximal depth is 4.0±0.08mm after immediately removal of the cream at 120 minutes application times. The decreasing analgesic effect occurred gradually but, at least, acceptable analgesic effect continues during 120minutes. In clinical appliance, the operation could be completed without further local or general anesthesia for harvesting split thickness skin and dermabrasion. The two of the 20 volunteers were shown paleness on the applied area but disappeared spontaneously within 1 hour. There were no systemic side-effect. We concluded that this EMLA is very useful anesthetics for physician, especially plastic surgeon. It is very effective for superficial skin surgery, for example, split thickness skin graft, dermabrasion and electrocautery without fear and discomfort which is shown by lidocaine injection.

5% EMLA cream과 20% Benzocaine gel의 도포마취 효능 비교

이대우,백병주,김재곤,양연미,소유려 大韓小兒齒科學會 2011 大韓小兒齒科學會誌 Vol.38 No.1

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. 이 연구의 목적은 도포마취제로서 5% EMLA cream과 20% Benzocaine gel의 구강 내 주사침 자입 및 마취제 주입시 전 /구치부 전정부와 구개부에서의 작용시간과 동통 감소 효과를 평가하기 위함이다. 두 가지 도포마취제는 양측성 무작위 단일 맹검법 분할 디자인으로 평가되었다. Phase I은 전/구치부 전정부와 구개부에 도포마취제를 도포한 후 각각의 도포마취제의 작용시간을 평가하였다. Phase II는 Phase I에서 측정된 시간을 기초로 각각의 도포마취제를 부위별로 적용하여 주사침 자 입 및 마취제 주입시 동통 감소 효과를 평가하였다. 평가를 위해 100-mm modified visual analog scale(VAS)를 이용하여 주관적인 동통 수치를 기록하였고, 맥박산소측정기(Pulse oximeter)를 사용하여 주사침 자입 및 마취제 주입 전후의 맥박수 를 관찰하여 객관적인 동통 감소 효과를 비교하였다. Phase I 실험결과 두 가지 도포마취제는 전치부가 구치부보다, 구개부가 전정부보다 더 긴 작용시간을 보였다. 전치부 구 개부를 제외한 모든 부위에서 EMLA cream이 Benzocaine gel보다 더 빠른 작용시간을 보였다. Phase II 실험결과 마취제 주입시 부위별 그룹에 따른 VAS Score를 보면 전치부와 구치부 구개부에서 EMLA cream이 Benzocaine보다 동통 감소 효 과에 있어 유의한 차이를 보였다(p<.05). 결론적으로 EMLA cream은 Benzocaine보다 전정부와 구개부 모두에서 빠른 작 용시간과 더 좋은 유지력을 나타냈다. 또한 EMLA cream은 Benzocaine보다 주사침 자입시 전치부 구개부를 제외한 모든 부위에서, 마취제 주입시 전치부와 구치부 구개부에서 Benzocaine에 비해 더 좋은 동통 감소 효과를 보였다.

EMLA 크림이 ampicillin sodium 항생제 피내반응검사에 미치는 효과

김진(Kim, Jin),강희영(Kang, Hee-Young) 기본간호학회 2011 기본간호학회지 Vol.18 No.1

Purpose: The purpose of this study was to identify the effects of EMLA cream (eutectic mixture of local anesthetics, lidocaine and prilocaine) on pain during ampicillin sodium intradermal (ID) skin test, and also to assess skin reaction after the skin test. Methods: Forty-three nurse-volunteers had skin tests with 0.01ml-0.05ml ampicillin sodium antibiotics. Skin tests were done on each forearm to compare the pain level of the skin test site after application of EMLA cream with the pain level when no EMLA cream was applied. EMLA cream was applied at the ID skin test site with an occlusive dressing for one hour. Pain was evaluated using a visual analogue scale and pain sensation using the short form McGill Pain Questionnaire. The transverse diameter of the wheal and redness was read right after and at 15 minutes after the skin test. The results were compared using independent t-tests. Results: Pain score and sensation with EMLA cream treatment were significantly lower than when EMLA cream was not applied. There was no difference in skin reactions; reading of the skin test was not affected by EMLA cream. Conclusions: EMLA cream was found to be an effective local anesthetic to relieve the pain of clients having ampicillin sodium antibiotics ID skin tests.

광역동 요법에 의한 보통 사마귀 치료에서 EMLA(R)의 진통 효과

최연진 ( Eon Jin Choi ),안지영 ( Ji Young Ahn ),박미연 ( Mi Youn Park ) 대한피부과학회 2008 大韓皮膚科學會誌 Vol.46 No.6

Background: Photodynamic therapy (PDT) in the treatment of warts is known to be a relatively effective and safe cure. However, the pain, which occurs during being exposed to a light source and after its exposure, is being reported to be the most frequent and serious limitation in this therapy. Objective: The purpose of this study is to examine whether the level of pain can be lowered, by comparing EMLA(R), which is a topical anesthesia, with placebo, during topical ALA-PDT, and to try to compare the range and characteristics in pain. Methods: Twenty two patients with common warts were treated with ALA-PDT twice in the interval of 4 weeks, and were divided into two groups by the random distribution table. The distribution was made so that the patients, who used EMLA(R) as the topical anesthesia given at the first visit, could use a placebo at the second visit, and so that the patients who used placebo at the first visit, could use EMLA(R) at the second visit. Thus, a randomized, double-blind, placebo-controlled crossover study was carried out. The pain was evaluated during the treatment, right after the treatment, and one day after the treatment by using Visual Analogue Scale (VAS). Also four different ranges of the pain and its six characteristics were evaluated. Results: Of the 22 patients with common warts who underwent this study. 1 patient, was completely cured after the first visit, and did not participate further in the study. The data of the patients with complete recovery wasn`t included in the final statistical analysis. As a result of the evaluation of pain, the mean VAS score that was measured during the treatment, right after the treatment, and one day after the treatment was measured to be a little lower in the case of applying EMLA(R) versus placebo, but a statistically significant difference was not observed. Regarding the degree of pain, regardless of applying EMLA(R), most patients felt painful locally on the surface, and the majority complained of burning and shooting pain. Conclusion: Dermatologists tend to routinely apply EMLA(R), prior to a procedure in order to decrease pain. However, as a result of this research, the routine use of EMLA(R) given at PDT is thought to be unreasonable. (Korean J Dermatol 2008;46(6):757∼760)