Eutectic mixture of local anesthetic (EMLA) decreases pain during humeral block placement in nonsedated patients.

Background: We evaluated the potential role of an euctectic mixture of local anesthetic (EMLA) cream application before performing midhumeral block.
Methods: Sixty patients undergoing surgery distal to the elbow amenable to a humeral block were prospectively recruited for the study. The patients were randomly allocated to 1 of 3 groups: Group E: topical EMLA cream 60 min before block plus 2 mL IV normal saline 5 min before procedure; Group P: topical sham cream plus 2 mL IV normal saline, and Group S: topical sham cream plus 0.1 microg/kg of sufentanil in 2 mL solution IV. Pain experienced during skin puncture, and overall pain for the whole procedure were rated using a 100-mm visual analog scale (0: no pain to 100: worst pain).
Results: Patients in Group E experienced less pain compared with those in Groups P and S (5 +/- 3 mm vs 33 +/- 20 mm and 30 +/- 18 mm, respectively, P < 0.0001). The pain experienced throughout the complete humeral block was more substantial in Group P than in Group E (P = 0.01).
Conclusion: The patients who received EMLA cream had less pain with needle puncture as well as throughout the performance of humeral block.