Surgery Book

http://www.fpnotebook.com/

EMLA creamAka: Eutectic Mixture of Local Anesthetic

Advertisement

  1. See Also
    1. Local Skin Anesthesia
    2. Digital Block
    3. Lidocaine Local Skin Anesthesia (Xylocaine)
    4. Lidocaine-Epinephrine-Tetracaine (LET Anesthesia)
  2. Indications
    1. Venipuncture
    2. Used prior to Local Anesthesia injection
  3. Ingredients
    1. Lidocaine 25 mg/ml
    2. Prilocaine 25 mg/ml
    3. Thickener, emulsifier, distilled water
    4. Buffered to pH of 9.4
  4. Technique
    1. Apply thick layer to skin surface
      1. Apply 1-2 grams per 10 cm^2
      2. Maximum dose 10 grams
    2. Cream applied to Epidermis
    3. Occlusive dressing applied (Tegaderm, Opsite)
    4. Held in place for 60-90 minutes
      1. Apply for only 5-30 minutes if over diseased skin
    5. Duration of anesthesia: 30-120 minutes
    6. Depth of penetration
      1. Applied for 60 minutes: 3 mm depth
      2. Applied for 90-120 minutes: 5 mm depth
  5. Advantages
    1. Minimal systemic absorption
    2. No skin distortion
  6. Contraindications
    1. Age under 1 month old
    2. Methemoglobinemia
    3. Not FDA approved for open skin or mucous membranes
      1. Has however been used in Laceration Repair
      2. Zempsky (1997) Ann Emerg Med 30:163
  7. References
    1. Pfenninger (1994) Procedures, Mosby, p. 135-155
    2. Kundu (2002) Am Fam Physician 66(1):99

Navigation Tree