EMLA

Since TCA in higher concentrations tends to produce increased scarring and hypopigmenta-tion, 70% glycolic acid solution was applied to the entire face of patients and diluted with water after 2 min. This was followed by the sequential application of EMLA cream (lidocaine 2.5% and prilocaine 2.5%) or ELA-Max cream (lidocaine 4%) to selected areas on the face for 30 min without occlusion. These agents were then removed and 35% TCA was applied to the entire face [10]. 

Koppel RA, Coleman KM, Coleman WP (2000) The efficacy of EMLA versus ELA-Max for pain relief in medium-depth chemical peeling a clinical and histopathologic evaluation. Dermatol Surg 26 61-64 Brody HJ (2001) Complications of chemical resurfacing. Dermatol Clin 3 427-437... 

True IgE-mediated anaphylactic reactions to LAs are extremely rare [11-13]. Only single cases have been reported in the literature with positive prick tests [ 14,15]. A case of a positive open patch test in a patient suffering from contact urticaria after topical application of lidocaine, pilocaine mixture (Emla cream) might represent a true IgE-mediated allergy [16]. The maj ority of immediate-type reactions are non-immune in nature. 

Waton J, Boulanger A, Trechot PH. Schmutz JL. Barbaud A Contact urticaria from Emla cream. Contact Dermatitis 2004 51 284-287. 

Benzocaine, cetacaine, EMLA cream, lidocaine, prilocaine, and... 

Similar to Voltaren" Emulgel, oily droplets of an eutectic mixture of lidocaine and prilocaine are dispersed in a hydrogel to provide local anesthesia to the skin for injections and siugical treatment (Emla cream). A further possibility is the dermal administration of a liposome dispersion as a spray (Heparin PUR ratiopharm Spriih-gel "). After administration, water and isopropylic alcohol evaporate partially resulting in an increase of concentration and in a transition from the initial liposome dispersion into a lamellar liquid crystal [32]. The therapeutic effect appears to be influenced favorably by the presence of lecithins rather than by the degree of liposome dispersion. 

Dibucaine (Nupercainal) Lidocaine Prilocaine (EMLA, LMX) Lidocaine/Tetracaine Transdermal (Synera)... 

III.b.8.1. Skin. Surface anaesthesia of the skin can be produced with help of a cream containing a eutectic mixture of local anaesthetics (EMLA), which is a water/oil emulsion of equal parts of prilocaine and lidocaine with particularly good penetration capacity. EMLA is applied under occlusion, around 40-60 minutes before the planned intervention. This is an effective way of producing anaesthesia before needle punctures and minor, painful, procedures. The method is excellent, particularly in paediatrics, to reduce fear and pain. 

EMLA cream can also be used in treatment of post-herpetic pain. When using EMLA on larger surfaces, e.g. in revision of pressure wounds, there is an increased risk of systemic toxic effects. The dose of EMLA should be adjusted according to the surface covered, type of intervention and depending on the skin being intact or not, or if a mucous membrane also is included. 

Percutaneous drug absorption can present special problems in newborns, especially in preterm infants. While the skin of a newborn term infant may have the same protective capacity as the skin of an adult, a preterm infant will not have this protective barrier until after 2 to 3 weeks of life. Excessive percutaneous absorption has caused significant toxicity to preterm babies. Absorption of hexachlorophene soap used to bathe newborns has resulted in brain damage and death. Aniline dyes on hospital linen have caused cyanosis secondary to methemoglobinemia, and EMLA (lidocaine/prilocaine) cream may cause methemoglobinemia when administered to infants less than 3 months of age. 

EMLA cream (lidocaine 2.5% and prilocaine 2.5%) consists of a eutectic mixture of focal anesthetics. It is used to provide topical anesthetic to intact skin. Other topical preparations are effective only on mucosal surfaces. EMLA has been shown to reduce pain on venipuncture and provide substantial anesthesia for skin graft donor sites. No significant local or systemic toxicity has been demonstrated. 

Rx with epinephrine (LidoSite, Xylocaine with Epinephrine) Prilocaine (EMLA) Cfiemical Class Amide derivative... 

Topical anesthetics such as EMLA cream, which is a mixture of lidocaine and prilocaine, can be quite effective in reducing pain associated with venipunture or intravenous line insertion, circumcision, and laser treatment of port wine stains (Wilder, 2000). 

EMLA cream (lidocaine (lignocaine) 2.5% and prilocaine 2.5%) is an emulsion in which the oil phase is a eutectic mixture of lidocaine and prilocaine in a ratio of 1 1 by weight. It is available in 5 g and 30 g tubes. It is also available as an anaesthetic disc. This consists of a single-dose unit of EMLA contained within an occlusive dressing. The disc contains 1 g EMLA emulsion, the active contact surface being approximately 10 cm2. The surface area of the entire anaesthetic disc is approximately 40 cm2. EMLA (1 g) contains lidocaine 25 mg, prilocaine 25 mg with thickening agents, water, NaHCOB, etc., at a pH of about 9. 

EMLA applied to intact skin provides dermal analgesia by the release of lidocaine and prilocaine from the cream into the epidermal and dermal layers of the skin. There is cumulation of lidocaine and prilocaine in the vicinity of dermal pain receptors and nerve endings. The quality and duration of dermal analgesia depends primarily on the duration of application. EMLA should be applied 1-2 hours before the planned intervention, e.g. venepuncture, split skin harvesting. 

Parenteral 10 mg/mL lidocaine plus 3.75 mg/mL bupivacaine for injection Lidocaine and prilocaine eutectic mixture (EMLA cream)... 

Clinical use Topical anesthesia is easily achieved using an eutectic mixture of the LAs prilocaine and lidocaine (EMLA, see Lidocaine). 

Katz, N.P., et al. 2004. Rapid onset of cutaneous anesthesia with EMLA cream after pretreatment with a new ultrasound-emitting device. Anesth Analg 98 371. 

Rogers TL, Ostrow CL. The use of EMLA cream to decrease venipuncture pain in children. J Pediatr Nurs. 2004 19 33-39. 

Lidocaine and etidocaine eutectic mixture (EMLA cream)... 

D EMLA Creme (Astral- Emlapatch (Astra) Emla (Astra Farmaccutici)-... 

Xylonest (Astra) EMLA (Astra)-comb. J Citanest (Astra-Fujisawa)... 

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