Emla-cream / Akorn, AstraZeneca - LARVOL DELTA

Adult circumcision using needle-free, topical EMLA cream (AUA 2025) - "The use of topical eutectic mixture of local anaesthetic (EMLA) cream (5% - 2.5% lidocaine and 2.5% prilocaine) in neonatal and paediatric circumcision is well described but very little in adult circumcision (1). Our study shows that adult men willing to undergo a circumcision under local anaesthesia, solely, using topical EMLA cream was safe and 100% effective when the cream was applied for at least 40 min. Our results are in contrast to those reported by Gyftopoulos (2), his study showed 20.5% effectiveness but topical EMLA was applied for only 20-30 min and furthermore, following EMLA cream application, an occlusive dressing was applied, the later may have contributed to uneven skin absorption, compounded by reduced application time of the EMLA cream. Dorsal penile block may be an effective alternative, when performing a circumcision but require a needle, blind administration and is operator-dependent and thus, not always effective (3)."

Clinical • Anesthesia • Infectious Disease • Pain • Pediatrics

Anaphylactic shock secondary to topical EMLA. (PubMed, J Cutan Aesthet Surg) - "Although side effects of EMLA are usually mild local skin reactions, rare complications such as methemoglobinemia, central nervous system toxicity, and cardiotoxicity can occur. Herein, we are reporting a case of anaphylactic shock to topical application of EMLA."

Journal • Aesthetic Medicine • Anesthesia • Cardiovascular • Dermatology • Hematological Disorders • Immunology • Urticaria

The Effects of EMLA Cream and Cold Application on Pain, Fear and Vital Signs Before Chest Tube Removal in Children (clinicaltrials.gov) - P=N/A | N=72 | Not yet recruiting | Sponsor: Istanbul Medeniyet University

New trial • Pain

Determining the duration of topical anesthetic drugs’ use for effective analgesia before various needle puncture procedures (ChiCTR) - P=N/A | N=288 | Not yet recruiting | Sponsor: Shanghai Changzheng Hospital; Shanghai Changzheng Hospital

New trial • Anesthesia • Pain

Pharmacological and Nonpharmacological Methods for Children in Venipuncture Pain (clinicaltrials.gov) - P=N/A | N=192 | Completed | Sponsor: Aynur Aytekin Ozdemir

New trial • Pain

Use of Cervical Cap and Menstrual Disc for Application of Topical Anesthetic Prior to IUD Insertion (clinicaltrials.gov) - P=N/A | N=24 | Not yet recruiting | Sponsor: Oregon Health and Science University

New trial • Anesthesia • Long-acting Reversible Contraceptives

Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion. (PubMed, J Am Board Fam Med) - "Moderately effective pharmacologic and non-pharmacologic methods exist for reducing pain and anxiety with IUD insertion. These treatment methods should be offered to create a more comfortable experience for patients. Additional research is needed to determine the comparative efficacy of these methods."

Journal • Review • Long-acting Reversible Contraceptives • Mood Disorders • Pain • Psychiatry • Women's Health

Myofascial Pain Syndrome: An Update on Clinical Characteristics, Etiopathogenesis, Diagnosis, and Treatment. (PubMed, Muscle Nerve) - "However, non-steroidal anti-inflammatory drugs, diclofenac, botulinum toxin, and transcutaneous electrical nerve stimulation show insufficient evidence, while the effectiveness of muscle relaxants, antidepressants, gabapentin, opioids, topical lidocaine, capsaicin, EMLA cream, and kinesio taping remains inconclusive. Effective management of MPS requires a patient-centered approach that integrates empirically supported and evidence-based treatments tailored to individual needs. This review synthesizes the current understanding of MPS and highlights the need for high-quality research to improve clinical decision-making in managing this complex condition."

Journal • Review • Anesthesia • Fibromyalgia • Musculoskeletal Pain • Neuralgia • Pain • Rheumatology

Local analgesia for the relief of pain in children undergoing venipuncture and intravenous cannulation: a systematic review and network meta-analysis. (PubMed, BMC Anesthesiol) - "Most local analgesia methods were effective in relieving pain in children undergoing venipuncture and intravenous cannulation except vapocoolant spray which did not show greater pain reduction than placebo or routine care. Amethocaine, Buzzy and lidocaine iontophoresis are the top 3 local analgesia methods to relieve pain in children undergoing venipuncture and intravenous cannulation. However, due to the limited number of direct comparisons, interpretation of some results should be made with caution."

Clinical • Journal • Retrospective data • Review • Pain

Clinicopathologic correlation in a case of irritant contact dermatitis caused by topical application of EMLA® cream (AAD 2025) - No abstract available

Clinical • Contact Dermatitis • Dermatitis • Dermatology • Immunology

Topical analgesia during needle-related procedures in children: a clinical practice guideline. (PubMed, Arch Dis Child) - "There is, however, uncertainty about the type of local anaesthetic (ie, eutectic mixture of topical analgesia (EMLA) or tetracaine-containing creams (eg, Rapydan) that should be used.Therefore, a clinical practice guideline (CPG) was developed to establish a comprehensive, evidence-based overview and provide recommendations for clinical practice.A comprehensive multidisciplinary panel was assembled, comprising 16 professionals and patient representatives in the Netherlands. We suggest the use of tetracaine-containing creams only when rapid cannulation/puncture (ie, within 30-60 min) is required (weak recommendation, very low-quality evidence).In this CPG, we provide recommendations regarding the choice of local anaesthetic for needle-induced pain during minor procedures in children. With these recommendations, we aim to reduce procedural pain and thereby contribute to improving care for children."

Clinical guideline • Journal • Anesthesia • Pain • Pediatrics

Ice Versus EMLA for Pain in Laser Hair Removal (clinicaltrials.gov) - P4 | N=30 | Active, not recruiting | Sponsor: Northwestern University | Phase classification: P=N/A ➔ P4 | Trial completion date: Dec 2024 ➔ Dec 2025 | Trial primary completion date: Dec 2024 ➔ Dec 2025

Phase classification • Trial completion date • Trial primary completion date • Aesthetic Medicine • Pain

Topical anesthetics methods used to reduce needle pain/discomfort prior to local anesthesia in children and adolescents: a scoping review. (PubMed, Evid Based Dent) - "Cooling is a technique with numerous clinical advantages from the clinical point of view, for reduction of pain/discomfort prior to needle puncture of dental local anesthesia in children and adolescents. It is an accessible, inexpensive and pleasant method that does not resemble needles or unpleasant tastes, nor involves systemic toxicity and complications that may be associated with others anesthetics agents. Future randomized controlled studies in accordance with the Consort Statement are needed to further investigate the topic."

Journal • Anesthesia • Pain

The safety study of EMLA cream for non-coring needle insertion in patients with TIAP (ChiCTR) - P4 | N=368 | Completed | Sponsor: Sun Yat-sen University Cancer Center; Sun Yat-sen University Cancer Center

New P4 trial • Oncology

EML4-ALK: Update on ALK Inhibitors. (PubMed, Int J Mol Sci) - "Since the discovery of the first-generation ALK inhibitor, many other tyrosine kinase inhibitors have been demonstrated to be effective in the first line or further lines of treatment in patients with advanced non-small cell lung cancer with EMLA4-ALK translocation...It presents the two options available for first-line treatment at the present time: sequencing different ALK inhibitors versus using the most potent inhibitor in front-line treatment. The efficacy outcomes of different ALK inhibitors in the first-line setting; the molecular profile of the disease, including mutation resistances and ALK variants and co-mutations; and patients' co-morbidities and inhibitor toxicities should be taken into account to address the choice of the first-line treatment, as suggested in this review."

Journal • Review • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Solid Tumor • EML4

Efficacy of 4% tetracaine gel and lidocaine-prilocaine cream in reducing local anesthetic injection pain in upper eyelid blepharoplasty: a randomized, single-blinded, controlled trial. (PubMed, BMC Ophthalmol) - P=N/A | "In comparison to LPC, 4% TG showed a stronger anesthetic effect on reducing injection pain after 60-minute application. It also generally presented a higher frequency of cutaneous reactions but didn't affect the eyelid edema 24 h postoperatively."

Clinical • Journal • Aesthetic Medicine • Anesthesia • Pain

Biological treatment of methyl orange dye and textile wastewater using halo-alkaliphilic bacteria under highly alkaline conditions. (PubMed, Extremophiles) - "This study aims to find a sustainable solution for dye removal by investigating the potential of an indigenously isolated bacterium, Nesterenkonia lacusekhoensis EMLA3 (halo-alkaliphilic) for treatment of an azo dye, methyl orange (MO) and textile effluent...Application of the bacterium to MO dye spiked real textile wastewater showed excellent dye removal. Phyto-toxicity assessment conducted on Vigna radiata and Triticum aestivum seeds, showed 100% germination of biotreated textile wastewater indicating its reuse potential."

Journal

Cerebral Changes Following Carpal Tunnel Syndrome Treated with Guided Plasticity: A Prospective, Randomized, Placebo-Controlled Study. (PubMed, J Brachial Plex Peripher Nerve Inj) - "Methods  Twenty-four patients with mild-to-moderate unilateral CTS were randomized to treatment with anesthetic cream (EMLA) or placebo...Conclusions  Stimulation of median nerve-innervated fingers in patients with unilateral CTS results in smaller-than-normal activation in the contralateral S1. Cutaneous forearm anesthesia on the side with CTS results in larger activation in S1, suggesting recruitment of more neurons, and a slight improvement in sensory function."

Journal • Anesthesia • Musculoskeletal Pain • Pain

Comparison Between Lidocaine Prilocaine Cream and Lidocaine Injection on Pain Control During Episiotomy. (clinicaltrials.gov) - P=N/A | N=60 | Completed | Sponsor: Cairo University | Active, not recruiting ➔ Completed

Trial completion • Pain

Reducing Port Access Pain and Clinic Wait Time: An Evaluation of EMLA Cream Versus nüm™ Vapocoolant Spray (clinicaltrials.gov) - P4 | N=0 | Withdrawn | Sponsor: Marianne Hutti | N=82 ➔ 0 | Enrolling by invitation ➔ Withdrawn

Enrollment change • Trial withdrawal • Oncology • Pain • Pediatrics

Topical Anesthesia in Cutaneous Head and Neck Surgery: A Randomized Controlled Trial. (PubMed, Otolaryngol Head Neck Surg) - "EMLA and EC did not mitigate LA-associated pain in patients undergoing cutaneous head and neck surgery and as such practitioners should reconsider their use of these in this regard. Patients' operative experience remains excellent regardless of topical anesthetic use."

Journal • Surgery • Anesthesia • Head and Neck Cancer • Oncology • Otorhinolaryngology • Pain • Skin Cancer

Efficacy of topical anesthetics of lidocaine, benzocaine, and EMLA in reducing pain during inferior alveolar nerve block in schoolchildren: a randomized controlled trial. (PubMed, BDJ Open) - "8% lidocaine gel was not superior to 20% benzocaine nor 5% EMLA in reducing pain during IANB administration."

Journal • Anesthesia • Pain

Dysfunction of the autonomic nervous system in gastro-esophageal reflux disease: Consequences for the cardiovascular system. (PubMed, Neurophysiol Clin) - "Our data suggests a high parasympathetic tone amongst patients with GERD and a dysregulation of parasympathetic and sympathetic balance in the cardiovascular system with an impairment of the peripheral sympathetic fibers of cutaneous microcirculation, assessed by the EMLA test. GERD may be an inaugural symptom of autonomic neuropathy. Further functional exploration of peripheral small fibers seems to be necessary."

Journal • Cardiovascular • Gastroenterology • Gastroesophageal Reflux Disease • Pain

Analgesic Efficacy of EMLA Cream Among Patients Undergoing Hemorrhoidectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, Cureus) - "This ultimately leads to increased patient satisfaction. However, further studies are still required to confirm these findings."

Journal • Retrospective data • Review • Gastroenterology • Pain

Push until it hurts: The impact of topical anesthetic on exercise-induced hypoalgesia (IASP 2024) - "Topical anesthetic (emla 2.5% topical) or topical placebo were placed on participants' quadriceps muscles for 30 mins5 in a 3cmx3cm square, after which pressure pain and muscle biomechanical6 testing (i.e., stress, strain, elasticity) was completed at all sites... Our preliminary findings indicate increased EIH independent of topical anesthetic application, suggesting muscle nociceptors may not be pivotal in the phenomenon. Sex may be an important factor for the effects of exercise and topical anesthetic on pressure pain ratings. Similar to previous data8, males responded strongly to the application of a topical anesthetic whereas females did not."

Anesthesia • Musculoskeletal Diseases • Musculoskeletal Pain • Pain