The Effects of EMLA on Pain Associated with Retrobulbar Injection

ABSTRACT

A prospective study was undertaken to assess the efficacy of the anesthetic cream EMLA (Eutectic Mixture of Local Anesthetics)in alleviating the pain of retrobulbar injection in patients undergoing cataract surgery.One-hundred forty-three patients who had undergone cataract surgery under local anesthesia in Korea Veterans Hospital from July 1999 to February 2000 were selected randomly into three groups and each of them had no significant difference in their age, sex and underlying conditions.Fifty-seven patients received the EMLA cream, 43 patients received the placebo and the remaining 43 patients received nothing.Among three groups, the EMLA group and the placebo group were double masked.The pain assessed subjectively by the patient was expressed in 11 scales (0-10).And the reactions of the patients to needle insertion, which had been objectively assessed by the one operator, were graded into 4 scales (0-3).No patient experienced serious side effects in each treatment group.In subjective grading, the EMLA group which had been graded as 2.91 +/-1.93 was proven to be more effective in reducing pain than the placebo group (6.2 +/-2.02)and the not-treated group (6.56 +/-1.64).In objective grading, the EMLA group (0.44 +/-0.63)was superior to the placebo group (0.98+/-0.99)and the no treated group (1.4 +/-0.13).In conclusion, local pretreatment using the EMLA cream to alleviate the pain on retrobulbar injection is one of good methods for enhancing the patient cooperation in cataract surgery with reduced anxiety.