EMLA cream anaesthesia for frenuloplasty

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Abstract
Objective To evaluate the use of a eutectic mixture of local anaesthetics (EMLA) cream as the sole anaesthetic for frenuloplasty. Patients and methods Fifteen patients (mean age 25.6 years, range 19–41) were given topical EMLA cream 30 min before frenuloplasty: a Tegaderm® dressing was applied to keep the anaesthetic in place. The level of anaesthesia was assessed on arrival in theatre using pin-prick testing and the patients were asked to grade their level of pain during the procedure using a visual analogue scale. If the level of anaesthesia was inadequate for the operation to be performed, then supplementary infiltrative anaesthesia was administered. Results Fourteen patients had pain scores of zero and were fully anaesthetized during the procedure. One patient's Tegaderm® dressing was displaced soon after application and he was inadequately anaesthetized on testing, had a pain score of 4 and required infiltrative lignocaine before proceeding with frenuloplasty. Conclusions EMLA cream is a well-tolerated and reliable anaesthetic for frenuloplasty. Using a condom to keep the cream in place would reduce the small failure rate associated with the displacement of the Tegaderm® dressing.