Do topical anesthetics reduce periareolar injectional pain before sentinel lymph node biopsy?

Abstract

Background: Topical anesthetics have been used in various procedures. The purpose of this study was to evaluate efficacy of lidocaine/prilocaine cream in decreasing the pain of injection for sentinel lymph node biopsy.

Methods: A prospective, randomized, placebo-controlled study was conducted on female breast cancer patients undergoing periareolar injection for sentinel lymph node isolation. Subjects applied lidocaine/prilocaine cream or a placebo cream before injection and completed a survey postoperatively.

Results: Twenty treatment and 19 control patients were studied. There was a trend for control subjects to indicate that the injection was "painful" or "extremely painful" more often than treatment subjects (52.6% vs 25.0%, respectively, P = .074). The treatment group was more likely to recommend the cream to other cancer patients (70.0% vs 42.1%), with a trend toward significance (P = .076).

Conclusions: This study showed no statistically significant reduction in pain scores in subjects receiving the topical anesthetic. Further studies targeting patients with low pain tolerance may prove more effective.