EMLA- AN EFFECTIVE TOOL FOR TOPICAL ANALGESIA IN SPLIT SKIN GRAFT HARVEST

LALIT AGRAWAL; FAHUD KHURRAM; NAVEEN KHUBCHANDANI

Volume : IX, Issue : IV, April - 2020

EMLA- AN EFFECTIVE TOOL FOR TOPICAL ANALGESIA IN SPLIT SKIN GRAFT HARVEST

Lalit Agrawal, Fahud Khurram, Naveen Khubchandani

Abstract :

Background: Many patients require general anesthesia merely for skin grafting. EMLA cream which is a eutectic mixture of Lignocaine and Prilocaine provides surface anesthesia when applied on intact skin. Its role in venepuncture or IV cannula insertion in children is well documented. Aim and Objective: To compare effectiveness of EMLA over infiltrative local anaesthesia in split skin graft harvest. Method: A prospective study was conducted on 64 patients who required skin grafting. Various indications for grafting were noted. The patients were randomly allocated to two groups. In one group 32 patients, graft was harvested after application of EMLA cream whereas in another group of 32 patients, graft was harvested by infiltrating local anesthesia. Pain perceived during donor area preparation, graft harvesting and post-operative pain was recorded and compared between the two groups on Visual analogue scale and Likert scale. Results: Total 64 patients were included in the study with 32 patients in either group. Traumatic loss of skin was the most common indication in either group for skin graft harvest. As per visual analogue scale during the graft harvest, most of the patients were in the range of 4-7 score in either group (71.87% vs 53.12%). 75% of the patients were in the 4-7 score in both groups. As per likert scale during the graft harvest score of 4 was noted in 62.5% in group 1 vs 53.12% in group 2 patients. 81.25% patients in group 1 reported procedure as excellent versus 53.12% patients in group 2. Patients experienced more pain during infiltration of local anesthesia. Whereas more bleeding was noted in EMLA group immediately after harvest of graft. Conclusions: EMLA cream can be effectively used as an alternative to local anaesthetic infiltration for harvest of split thickness skin graft.