Premium
Comparison of lidocaine/tetracaine cream and lidocaine/prilocaine cream for local anaesthesia during laser treatment of acne keloidalis nuchae and tattoo removal: results of two randomized controlled trials
Author(s) -
Greveling K.,
Prens E.P.,
Bosch N.,
Doorn M. B.
Publication year - 2017
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14848
Subject(s) - medicine , lidocaine , prilocaine , tetracaine , anesthesia , visual analogue scale , randomized controlled trial , topical anesthetic , adverse effect , local anesthetic , local anesthesia , surgery
Summary Background Pain is a common adverse effect of dermatological laser procedures. Currently, no standard topical anaesthetic cream exists for deeper dermal laser procedures. Objectives To compare the efficacy of lidocaine/tetracaine cream and lidocaine/prilocaine cream in reducing self‐reported pain during deeper dermal laser treatment of acne keloidalis nuchae ( AKN ) and tattoos. Methods We conducted two randomized, double‐blind, controlled clinical trials with intrapatient, split‐lesion designs: study A included patients with AKN ( n = 15); study B included patients with black tattoos ( n = 15). The primary end point was the patients’ self‐reported pain on a 10‐cm visual analogue scale ( VAS ). Secondary objectives were the percentage of patients with adequate pain relief, willingness to pay €25 for the cream that provided the best pain relief and safety of the creams. Results In both studies, VAS scores were lower for lidocaine/prilocaine cream, with a mean VAS difference in study A of 1·9 [95% confidence interval ( CI ) 1·0–2·8] and in study B of 0·6 (95% CI −0·7 to 1·9). In study A, adequate pain relief was achieved in 13% ( n = 2) with lidocaine/tetracaine cream vs. 73% ( n = 11) with lidocaine/prilocaine cream ( P = 0·004), and in study B in 53% ( n = 8) vs. 80% ( n = 12), respectively ( P = 0·289). In study A, 47% ( n = 7) were willing to pay an additional €25 vs. 73% ( n = 11) in study B. No serious adverse events occurred. Conclusions Lidocaine/prilocaine cream under plastic occlusion is the preferred topical anaesthetic during painful laser procedures targeting dermal chromophores.