Analgesic Efficacy and Patient Acceptability of Topical Eutectic Mixture of Local Anesthetics versus Local Lignocaine...

Needle prick pain during subarachnoid block (SAB) may increase anxiety and reduce cooperation in parturients. Topical eutectic mixture of local anesthetics (EMLA) cream provides needlefree dermal analgesia, while lignocaine infiltration necessitates an additional injection.

We compared pain perception and acceptability between EMLA cream application versus lignocaine infiltration before SAB in elective lower segment cesarean section (LSCS).

In this prospective, randomized, openlabel study, 60 American Society of Anesthesiologists II-III parturients aged 18-40 years undergoing elective LSCS were randomized to Group A (EMLA cream applied 1 h before SAB) or Group B (2% lignocaine infiltration 5 min before SAB). Pain during spinal needle insertion was assessed using a visual analogue scale (VAS). Secondary outcomes included comfort score, ease of insertion, number of attempts, time required for successful SAB, and hemodynamic responses.

VAS pain scores were significantly lower in Group A (2.9 ± 0.8) compared to Group B (5.9 ± 0.7). Time taken for SAB was shorter in Group A (2.8 ± 0.8 min) versus Group B (4.9 ± 0.8 min). High comfort was reported by 33.3% in Group A and none in Group B, while low comfort was reported by 50% in Group B. Ease of insertion was higher in Group A (50%) than in Group B (16.7%). Hemodynamic parameters were comparable.

EMLA cream significantly reduced pain, improved comfort, and facilitated easier spinal needle insertion compared with lignocaine infiltration. It offers a simple, needlefree, patientfriendly alternative for enhancing the SAB experience in parturients.