Local anaesthesia with a lidocaine/prilocaine cream (EMLA) for cautery of condylomata acuminata on the vulval mucosa. The effect of timing of application of the cream.

The analgesic efficacy of a lidocaine/prilocaine cream (EMLA) for the cautery of genital warts was evaluated in an open study. Fifty-two women aged 18 to 28 with at least two condylomata on the vulval mucosa took part. In a pilot study (n = 10) the time of onset of anaesthesia after the application of EMLA to the mucosa was established by pinching with a forceps. All ten patients were anaesthetized within 5-7 min and cautery was performed with no or only slight pain in 9/10 patients. In the main study EMLA was applied to the mucosa of 42 women for 10, 15 or 20 min. The anaesthesia was satisfactory for the cautery of condylomata in 92% of the patients after the application of EMLA for 10 minutes. The analgesic efficacy decreased gradually with application times of 15 min or longer (p less than 0.05). In the case of insufficient anaesthesia, an additional application of EMLA for 2-5 min enabled the operations to be completed in 7/8 patients.