EMLA does not permit pain-free retrobulbar injection.

Abstract

Retrobulbar injection can be associated with significant pain, due to both needle insertion and deposition of the local anaesthetic solution. The local anaesthetic cream EMLA (eutectic mixture of local anaesthetics) which contains a mixture of lignocaine and prilocaine has been shown to reduce the pain associated with skin puncture. The efficacy of EMLA in alleviating the pain of retrobulbar injection for cataract surgery was assessed in this study. In this, randomised double-blind study, EMLA (n = 53) or lignocaine 5% ointment (n = 50) was administered to the inferior orbital margin at least 45 min before retrobulbar block in 103 patients. Pain assessed during retrobulbar block was marked subjectively by the patient on a 10-point numerical rating scale. Median verbal pain scores were 3.0 with an interquartile range of 1.5-6.5 in the control group and 3.50 with an interquartile range of 2.0-6.0 in the EMLA(R) group (P = 0.67). There was no significant difference between the EMLA group and the lignocaine ointment group according to this pain assessment. EMLA does not permit pain-free retrobulbar injection.