Evaluation of eutectic lidocaine/prilocaine cream (EMLA®) for steroid joint injection in children with juvenile rheumatoid arthritis: A double blind, randomized, placebo controlled trial

Objective. To evaluate the efficacy of eutectic lidocaine/prilocaine cream (EMLA®) in reducing the pain associated with steroid joint injection in children with juvenile arthritis. Methods. A randomized, double blind, placebo controlled parallel group trial. Thirty-one children (ages 8-18 yrs) scheduled for steroid injection into a knee were randomized into groups having either 2.5 g lidocaine/prilocaine cream or placebo cream applied to the injection site 60-90 min before the procedure. Patients assessed the pain associated with initial needle insertion and subsequent steroid injection using a 10 cm visual analog scale. Results. No significant difference was found in the pain reported after needle insertion or steroid injection between the lidocaine/prilocaine cream group (n = 17) and the placebo group (n = 14). There was a trend toward an association of lower median scores with the pain of steroid injection in the lidocaine/prilocaine group (6 mm) compared with the placebo group (22 mm). Conclusion. Application of 2.5 g lidocaine/prilocaine cream for 60-90 min had no statistically significant analgesic effect on pain associated with injections of steroids into the knees of children with juvenile arthritis.