Authors: Koscielniak-Nielsen, Z.¹; Hesselbjerg, L.²; Brushøj, J.²; Britt Jensen, M.³; Stens Pedersen, H.³

Source: Anaesthesia, Volume 53, Number 12, December 1998 , pp. 1218-1222(5)

Publisher: Wiley-Blackwell

Abstract:

We have prospectively assessed pain and anxiety of spinal puncture in 180 adult patients randomly allocated to one of three equal groups. On the morning of surgery group 1 had an EMLA patch, whereas group 2 and 3 had placebo patches. Group 2 also had infiltration analgesia with 2 ml lignocaine 2% with adrenaline, immediately before the block. Spinal anaesthesia was performed with 25 gauge sharp needles without introducer or 25,27 gauge blunt needles with 20,22 gauge introducers. Patients assessed the spinal puncture pain on a 10-cm visual analogue scale immediately after removal of the needle. Pain scores were significantly lower in group 1 (EMLA), median 0.75, than in group 2 (placebo, infiltration analgesia), median 1.75, and group 3 (placebo), median 1.80, p < 0.0001. Pain intensity was less than expected in more patients in the EMLA group than in the other two groups, p = 0.034. However, the decision to accept/reject spinal anaesthesia in the future was not influenced by the pain of lumbar puncture. We conclude that application of an EMLA patch is a simple and effective method to provide adequate analgesia for spinal puncture, which also helps to allay patients' fears of spinal anaesthesia.

Keywords: Anaesthetics; local; EMLA cream; Anaesthetic techniques, regional; spinal, topical; Pain; lumbar puncture

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1365-2044.1998.00608.x

Affiliations: 1: Consultant Trainee Registrar, 2: Trainee Registrar, 3: Senior Registrar, Departments of Anaesthesiology and Intensive Care, Copenhagen University Hospital, Rigshospitalet and Frederiksberg Hospital, Copenhagen, Denmark

Publication date: 1998-12-01

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