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ARTIKEL ASLI
DIRECT COMPARISON OF CREAM AND CREAMY-GEL TOPICAL ANESTHETICS: A STUDY OF THE ELECTROFULGURATION-INDUCED PAIN
Suswardana, Nafiah Chusniyati, Yohannes Widodo Wiryohadidjojo
Bagian/SMF IK Kulit dan Kelamin FK Universitas Gadjah Mada/RSUP Dr. Sardjito - Jl. Kesehatan 1, Skip, Yogyakarta
ABSTRAK

Telah dilakukan uji klinis acak, buta ganda, komparatif-paralel, intra-individual membandingkan efikasi Eutectic mixture of local anesthetics (EMLA) dalam formulasi berbentuk krim dan creamy-gel untuk mengontrol nyeri akibat elektrofulgurasi pada 34 relawan. Pada punggung mereka digambar 2 kolom dengan 8 lajur dengan pengaturan oklusi selama 10, 20, 30, 45, 60, 90 dan 120 menit. Lajur teratas digunakan untuk control nyeri tanpa aplikasi EMLA. Sensasi nyeri yang ditimbulkan tindakan elektrofulgurasi pada masing-masing lokasi dinilai menggunakan metode Numerical Rating Scale (NRS).

            Perbedaan nilai NRS kedua kelompok tidak bermakna mulai menit ke 10 (p=0,158), 20 (p=0,689), 30 (p=0,667), 45 (p=0,652), 60 (p=0,860), 90 (p=0,565) sampai menit ke 120 (p=0,642). Kedua kelompok menunjukkkan adanya korelasi negative yang sangat kuat antara lamanya oklusi dan nilai NRS dan keduanya mencapai keaaan analgesia kutan adekuat pada menit ke 45.

            Dapat disimpulkan bahwa formulasi EMLA dalam vehikulum berbentuk creamy-gel memiliki efikasi yang setara dengan vehikulum krim

 

Kata kunci: EMLA, sediaan creamy-gel, elektrofulgurasi.

 

ABSTRACT


A randomized, double blind clinical trial to compare the efficacy of Eutectic Mixture of Local Anesthetics (EMLA) in a cream versus a creamy-gel vehicle formulation, in pain control for electrofulguration procedures.The back of each subject was used as an intervention unit, either for cream or creamy-gel group. Both drugs were applied randomly, in an occlusive dressing, in two rows of eight circular patches randomly. Pain intensity was recorded for both groups over time from minute 0, 10, 20, 30, 45, 60, 90 and 120. A second of 20 mA electrofulguration induced the pain, while Numerical Rating Scale (NRS) measured the pain intensity.


No significant NRS difference was found between two groups from minute 10 (p=0.158), 20 (p=0.689), 30 (p=0.667), 45 (p=0.652), 60 (p=0.860), 90 (p=0.565) and 120 (p=0.642). Adequate cutaneous analgesia was achieved in minute 45 for both groups with pain reduction of 86.8 % and 88.0% for the creamy-gel and cream group, respectively. There was a negative and strong correlation (R=-0.914; p=0.000) between pain sensation as measured by NRS and the duration of occlusion for both groups.


It is concluded that EMLA in a creamy-gel vehicle formulation has equal efficacy compared to the previously well-established EMLA which is in a cream vehicle.


 


Keywords: EMLA, creamy-gel vehicle, electrofulguration


 


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