EMLA cream for carpal tunnel syndrome: how it compares with steroid injection.
Author(s): Moghtaderi AR, Jazayeri SM, Azizi S
Affiliation(s): Shiraz University of Medical Sciences, Shiraz, Iran. moghtaderia@yahoo.com
Publication date & source: 2009-09, Electromyogr Clin Neurophysiol., 49(6-7):287-9.
Publication type: Comparative Study; Randomized Controlled Trial
BACKGROUND: A standard treatment option for carpal tunnel syndrome (CTS) is local injection of anesthetic-corticosteroid. This clinical trial was designed to compare the safety and efficacy of daily application of the EMLA cream (lidocaine 2.5% plus prilocaine 2.5%) with that of a single injection of methyl prednisolone acetate (Depo-Medrol) 40 mg. METHODS: In this randomized, parallel-group, open-label, single-center, case-controlled, prospective study, 65 participants (70 hands) aged 18-75 years with clinical & electrodiagnostic evidences of CTS were randomized to receive either the EMLA cream (n = 30 patients, 35 hands, group 1) or one injection of methylprednisolone acetate 40 mg at wrist (n = 35 patients, group 2). Outcome assessments included the visual analog scale and clinical assessment. RESULTS: After 4 weeks of treatment, patients in both groups reported significant changes (P < 0.001) in pain intensity. Both treatments were well tolerated, with treatment-related adverse events (AEs) reported in 2 patients in group 1 (5.7%) and 10 patients in group 2 (28.5%) No systemic treatment-related AEs were observed with the EMLA cream. CONCLUSION: EMLA cream was effective in reducing pain associated with CTS and well tolerated and it may offer patients with CTS an effective, noninvasive symptomatic treatment.
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