Anesthetic potential of lidocaine/prilocaine cream versus placebo before venepuncture


  • Varsha P. Gajbhiye 1Department of Pharmacology, J.N. Medical College, Wardha, Maharashtra, India
  • Y. R. Lamture Department of Surgery, J.N. Medical College, Wardha, Maharashtra, India



Prilocaine, Venepuncture, VAS score


Background: Pain associated with venepuncture has long been accepted as an unavoidable consequence. Many studies show reducing pain during venepuncture after application of prilocaine/lignocaine, but there are few studies that has depicted, the depth of anesthesia produced by prilocaine/lignocaine tends to be too superficial for the reducing the pain during venepuncture. These two scenarios were debatable. Therefore, authors planned a study to assess anesthetic potential of lidocaine /prilocaine cream versus placebo before venepuncture with help of VAS in an adult patient who were drawn blood sample for investigation purposes.

Methods: Prospective interventional study. All adult patient for blood sampling from surgery OPD to central laboratory were included in study. Site of venepuncture selected in both control and study group was left cubital fossa. 30 patients selected in study group received lignocaine/prilocaine locally, 30min prior to venepuncture which was later covered with occlusive tape, whereas 30 control group patient received normal saline locally as placebo. The extent of pain was assessed by patient on 10cm visual analogue scale (VAS) with end points of 0 cm rated as no pain and the points of 10cm as intolerable pain.

Results: A total of 60 patient were randomly selected who were referred from surgery OPD for blood sampling. Other 30 patient were applied normal saline as placebo and 30 patient with lignocaine and prilocaine cream. In the control group there were 30 patients (5 female and 25 male). In the study group there were 30 patients (8 females and 22 males). The level of pain among study group is as follows: mild 22, moderate 7, worst 1 and in control group: no pain 0, mild 5, moderate 14 and worst pain 1. Statistical analysis between outcome of two groups done by calculating chi-square test. Chi- square test was 20.0263. P value is 0.000168. Hence the result is significant at p <0.05.

Conclusions: The present study shows that prilocaine-lidocaine cream reduces the pain of needle puncture in adults and facilitates the procedure of venous blood sampling.


Ramsay MA. A survey of pre-operative fear. Anaesthesia. 1972 Oct;27(4):396-402.

Blom GE. The reactions of hospitalized children to illness. Pediatrics. 1958 Sep 1;22(3):590-600.

Brechner VL, Cohen DD, Pretsky I. Dermal anesthesia by the topical application of tetracaine base dissolved in dimethyl sulfoxide. Ann New York Acad Sci. 1967 Mar;141(1):524-31.

Dalili H, Adriani J. The efficacy of local anesthetics in blocking the sensations of itch, burning, and pain in normal and “sunburned” skin. Clin Pharmacol Therapeutics. 1971 Nov 1;12(6):913-9.

Ehrenström Reiz R. NA GM, Reiz SL. EMLA‐a eutectic mixture of local anesthetics for topical anaesthesia. Acta Anaesthesiol Scand. 1982 Dec;26(6):596-8.

Giovannetti JA, Bennet CR. Assessment of allergy to local anesthetics. Am Dent Assoc. 1979;98:701-6.

Scott J, Huskisson EC. Vertical or horizontal visual analogue scales. Ann Rheumatic Dis. 1979 Dec 1;38(6):560.

Daneshkazemi A, Abrisham SM, Daneshkazemi P, Davoudi A. The efficacy of eutectic mixture of local anesthetics as a topical anesthetic agent used for dental procedures: a brief review. Anesthesia Essays Res. 2016 Sep;10(3):383.

Menter A, Black-Noller G, Riendeau LA, Monti KL. The use of EMLA cream and 1% lidocaine infiltration in men for relief of pain associated with the removal of genital warts by cryotherapy. J Am Acad Dermatol. 1997 Jul 1;37(1):96-100.

Kumar S, Kumar S, Ganesamoni R, Mandal AK, Prasad S, Singh SK. Dimethyl sulfoxide with lignocaine versus eutectic mixture of local anesthetics: prospective randomized study to compare the efficacy of cutaneous anesthesia in shock wave lithotripsy. Urological Res. 2011 Jun 1;39(3):181-3.

Russo JE, Lipman AG, Comstock TJ, Page BC, Stephen RL. Lidocaine anesthesia: comparison of iontophoresis, injection, and swabbing. Am J Health System Pharmacy. 1980 Jun 1;37(6):843-7.

Hallen B, Carlsson P, Uppfeldt A. Clinical study of a lignocaine-prilocaine cream to relieve the pain of venepuncture. Br J Anaesthesia. 1985 Mar 1;57(3):326-8.

Pettersson LO. Percutaneous anaesthesia for taking split skin grafts. Scand J Plastic Reconstructive Surg. 1977 Jan 1;11(1):79-82.

Rapperport S. Adjunctive uses for iontophoresis. In: Fifth International Congress of Plastic and Reconstructive Surgery 1971:797-802.

Harrison N, Langham BT, Bogod DG. Appropriate use of local anesthetic for venous cannulation. Anaesthesia. 1992 Mar;47(3):210-2.

Armstrong P, Young C, McKeow D. Ethylchloride and venepuncture pain: a comparison with intradermal lignocaine. Can J Anaesth. 1990;37:656-8.

Langham BT, Harrison DA. Local anesthetic: does it really reduce the pain of insertion of all sizes of venous cannula?. Anaesthesia. 1992 Oct;47(10):890-1.

Dexter F, Chestnut DH. Analysis of statistical tests to compare visual analog scale measurements among groups. Anesthesiology: J Am Soc Anesthesiologists. 1995 Apr 1;82(4):896-902.




How to Cite

Gajbhiye, V. P., & Lamture, Y. R. (2018). Anesthetic potential of lidocaine/prilocaine cream versus placebo before venepuncture. International Journal of Basic & Clinical Pharmacology, 7(12), 2401–2404.



Original Research Articles