DOI: 10.14260/jemds/2015/2159 ORIGINAL ARTICLE J of Evolution of Med and Dent Sci/ eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 4/ Issue 87/ Oct. 29, 2015 Page 15191 USE OF TOPICAL ANAESTHESIA WITH EMLA CREAM FOR HARVESTING SPLIT SKIN GRAFT Premraj Nagarwal 1 , Anuraj Dubey 2 , Durga Jethava 3 , Ashish Jain 4 , Gaurav Goyal 5 , Varun Chhabra 6 HOW TO CITE THIS ARTICLE: Premraj Nagarwal, Anuraj Dubey, Durga Jethava, Ashish Jain. Gaurav Goyal, Varun Chhabra, “Use of Topical Anaesthesia with EMLA Cream for Harvesting Split Skin Graft”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 87, October 29; Page: 15191-15200, DOI: 10.14260/jemds/2015/2159 ABSTRACT: Harvesting a split skin graft is a painful procedure. A eutectic mixture of lidocaine and prilocaine (5% EMLA) which is capable of anaesthetizing intact skin is useful in this regard. AIMS AND OBJECTIVES: To evaluate the efficacy of anaesthetic effect and safety provided by topical application of EMLA cream for harvesting split skin graft and to compare the results of ELMA with or without sedative analgesic premedication. MATERIAL AND METHODS: All patients were randomly divided into two groups of 25 each. Group A (EMLA cream 10-15g/100cm 2 area) and Group B (EMLA cream 10-15g/100cm 2 area along with inj. Hydroxyzine hydrochloride 1mg/kg IM, inj. Midazolam hydrochloride 0.04mg/kg IV. and inj. Pentazocine 0.5mg/kg IV). Vital parameters, verbal pain score and satisfaction scores were recorded and compared in both groups. RESULTS: There were no statistically significant differences in pulse, Diastolic B.P (DBP) and respiratory rate between two groups. Systolic B. P (SBP) shows statistically significant difference (P value <0.05) at 45 min. and VPS shows statistically highly significant difference (P value <0.001) between 2 hours to 5 hours and significant difference (P value <0.05) at 1 hour and 6 hour. Only 20% of the patients in group A and 12% of the patients group B had pain of more than mild degree (VPS grade 1) and need intravenous ketamine supplement to complete the surgery. CONCLUSION: Topical use of EMLA cream is a safe, effective and convenient method of harvesting spilt skin graft and by using this method, we can avoid the hazards associated with general anaesthesia. We recommend this method as a routine especially in those patients who are not fit or high risk for anaesthesia. (Word 278). KEYWORDS: Split Skin Graft, EMLA Cream. INTRODUCTION: Pain is an "Unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage". In the recent practice of reconstructive plastic surgery split skin grafting is a very useful procedure where epidermis and a variable thickness of dermis is completely freed from its native blood supply are transplanted to a recipient site. Harvesting a split skin graft is a painful procedure; various methods have been used to relieve pain during this procedure including infiltration anaesthesia, (1) nerve block, regional, general, and topical anaesthesia. In high risk patients in whom regional and general anaesthesia is contraindicated, topical anaesthesia can be used to avoid associated complications of general anaesthesia in these patients. Topical anaesthesia remains a safe modality for pain relief prior to cutaneous procedure. With the emergence of new laser and surgical technique the need for more effective topical anaesthetic agent continues to grow. Now a day there are several new topical anaesthetic agents that are being used prior to various dermatological procedures. The main problem with topical anaesthetic agent delivery after application to skin is stratum cornium.