Applicazioni cliniche di una crema lidocaina/prilocaina (EMLA„µ) nel prelievo di innesti cutanei a tutto spessore

Abstract

EMLA® is a cream containing an eutectic mixture of local anaesthetics for topical use. Its anaesthetic action is maximal about two hours after application and is evident even beyond the cutaneous layer, as proved by several prior studies. Such features have induced the Authors to theorize its possible use in anaesthesia of the donor area of full thickness skin grafts. The aim of our study was to ascertain 'in vivo' the truthfullness of our proposition and to observe the possibility of a different response according to dosage, site and length of application. The trial was conducted on 24 patients who all required excision of skin lesions and subsequent repair with full thickness grafts. Most of the patients were elderly with medical problems, mainly of cardiovascular origin, and therefore at risk if given large doses of local anaesthetics. For donor areas we used the postauricular, supraclavicular and the inner arm. Application lasted between 90 and 120 minutes. Patients were asked to report pain on a 0-10 scale during the whole procedure. The donor area was closed by direct suture. In all 24 patients surgery was completed and in 17 of them EMLA® cream provided adequate anaesthesia during the whole procedure. Differences in pain control were reported for the different donor areas only