(082) EFFICACY OF EMLA CREAM FOR OFFICE-BASED ANDROLOGY PROCEDURE UNDER LOCAL ANESTHETIC: A RANDOMIZED CONTROLLED STUDY

Abstract Introduction There has been an increasing number of office base urology procedure performed under local anesthesia (LA), although it can be associated with needle phobia and pain. EMLA (Eutectic Mixture of Local Anesthetic) is a topical anesthetic cream that is used in office-based urology procedures. However, its use in more involved/invasive andrology and male-infertility procedures such as hydrocelectomy, spermatocelectomy, and others remain poorly studied. Objective We hypothesized that pre-application of EMLA cream in office-based andrology and male-infertility procedures may provide better pain control and overall experience for patients. Methods A double-blinded randomized controlled trial was conducted for patients undergoing scrotal andrology surgeries under LA. Power calculation was performed with an estimated sample size of 72. Participants were randomly assigned in a 1:1 ratio to topical EMLA + LA vs LA alone. In the post-operative recovery area, patient will be asked to complete a VAS questionnaire rating pain with LA administration and pain with procedure. Analysis comparing VAS pain scores of both groups was performed using the independent sample t-test method. Results 72 patients were included in our analysis, with 36 in the control and 36 in the intervention arm. For patient pain with administration of LA, the control arm reported an average VAS pain score of 4.31, compared to 3.72 in the intervention arm (p = 0.319). For patient pain with procedure, patients in the control arm reported a median VAS pain score of 3.47 compared to 3.03 (p = 0.432) in the intervention arm. Overall, 86% (62/72) of patients reported that they would either be “very likely” (4/5) or “highly likely” (5/5) to undergo future procedures under local anesthetic. Conclusions Performing scrotal surgeries under LA appears to be well tolerated and feasible option. Pre-application of EMLA cream does not appear to significantly patient reported outcomes. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.