Topical Analgesia

Introduction

Topical analgesia applies to analgesia at any surface, commonly the skin and mucous membranes such as mouth, genital tract and tracheobronchial tree.

Agents

• Agents are commonly found as creams, gels or sprays, and include lidocaine and EMLA cream.
• Some injectable agents can be used also be used topically.
• Care should be taken when applying the cream - Gloves should be worn.
• Agents which freeze the skin surface, such as ice or ethyl chloride spray, may also be used as it provides a degree of analgesia but is very superficial and care should be taken when using these substances as can lead to skin necrosis.

Uses

• On venopuncture sites prior to catheter placement.
• Passing of urinary catheters.
• Placement of endotracheal tubes.
• Procedures in the nasal cavity.
• For opthalmic examination and surgical procedures.

Advantages

• Easy Application - Requires no specific skills or expensive equipment.
• Repeat doses possible.

Disadvantages

• Superficial Analgesia.
• Variable in duration of action.