Dee/ 'CAINES' ?? EMLA or ELA-Max???

[Guest guest]

Thanks Dee – I am going to see if I can find some of that stuff,

just in case the other stuff wears off.

nne

From:

VulvarDisorders [mailto:VulvarDisorders ] On

Behalf Of Dee Troll

Sent: Saturday, June 07, 2008 4:00 AM

To: VULVAR DISORDERS LIST

Subject: 'CAINES' ?? EMLA or ELA-Max???

HI all... seeing the

EMLA cream mentioned and soooo glad that worked so well for you nne.

I knew it was one of the 'caines' as I think someone asked what

it was and from what I remember it's a combination of lidocaine &

prilocaine together, but wondering if anyone has tried ELA-Max?

It's a newer

'caine' out there and supposedly much better than EMLA or other 'caines' so

some physicians say. Here's one abstract. But I also added a few

other pieces below (4) on the 'caines' as I found them together in

my own files. (which I thought I lost *grin*)

Dee~

========================

1.

Title: Study on the

efficacy of ELA-Max (4% liposomal lidocaine) compared with EMLA cream

(eutectic mixture of local anesthetics) using thermosensory threshold

analysis in adult volunteers

Author(s):

MBY Tang ; ATJ Goon ; CL Goh

Source:

Journal of Dermatological Treatment Volume: 15

Number: 2 Page: 84 -- 87

DOI:

10.1080/09546630310018491

Publisher:

Dunitz, part of & Francis Health Sciences

Abstract:

BACKGROUND: ELA-Max and EMLA cream are topical anesthetics that have been

shown to have similar anesthetic efficacy in previous studies.

OBJECTIVE:

To evaluate the analgesic efficacy of ELA-Max in comparison with EMLA cream

using a novel method of thermosensory threshold analysis.

METHODS:

A thermosensory analyzer was used to assess warmth- and heat-induced pain

thresholds.

RESULTS:

No statistically significant difference was found in pain thresholds using

either formulation. However, EMLA cream increased the heat-induced pain

threshold to a greater extent than ELA-Max. Thermosensory measurement and analysis

was well tolerated and no adverse events were encountered.

CONCLUSIONS:

EMLA cream may be superior to ELA-Max for heat-induced pain. This study

suggests that thermosensory measurement may be another suitable tool for

future topical anesthetic efficacy studies.

© Journal of Dermatological

Treatment 2004

========================================================

2. (NO idea of when this was

written or if EMLA was taken off the market then brought back as he

suggests here) Dee

I

am a gynecologist and on several of the V. groups, Due to the voluminous

numbers of messages on the message board, I can't keep up with all of the

correspondence that occurs but I do try to pay attention to the overall themes

that occur at the vulvodynia group site...

My

purpose at this site is not to advance my personal practice, but to try and

inform people of the knowledge I've acquired over the past ten years that I've

been treating this condition. I've found this condition very challenging to

treat in some patients at times, and at times, very easy to eliminate and

treat. I am not a researcher; I am a clinical practitioner with some very

rewarding success stories over the years.

At any rate, in response

to the use of Lidocaine to facilitate

sexual intercourse, I

have not personally found this treatment

satisfying for the

majority of women with dysesthetic vulvodynia.

However,

the use of 3.5% prilocaine (EMLA cream) applied to the

introitus of the vagina

and any sensitive areas of the vulva works

wonders for the majority

of women.

Unfortunately,

EMLA was taken off the market by the manufacturer about two years ago and was

to be reformulated and placed back on the market. I've never really gotten a

good answer as to why (it's safe) and I've also never gotten a good answer as

to when it will return to the market.

In

the meantime, I've had compounding pharmacists make this preparation for me for

the past two years.

I

have women apply EMLA to the vulva and introitus of the vagina about one hour

prior to attempted intercourse and it will numb these tissues allowing

penetration.

Note

that it will also numb the clitoris so pay attention to where

it's applied unless you

also have clitoral area vulvodynia. Also,

some patients experience

burning at the initial application

(especially those with

chronic vulvitis) but I've only had two women who absolutely cannot use

EMLA due to burning but they did well using topical 20% benzocaine.

I'm not sure if the use

of EMLA has previously been discussed on the message boards and if it has, I

apologize for duplication. I merely felt like I should add my two cents worth.

=================================

3. http://www.emla-us.com/facts/

(LINK IS DEAD) so I added article, Using EMLA presurgical? Or maybe biopsy? Not

sure but interesting...Dee

Error! Filename not specified.

( EMLA = LIDOCAINE 2.5% & PRILOCAINE 2.5%

EMLA

is a unique product that numbs your child's skin at the injection site and

makes needle insertions and other procedures less painful. EMLA can only be

prescribed by your child's doctor, but can easily be applied at home before

the procedure.

Applying EMLA

EMLA Cream or EMLA Anesthetic Disc should be applied 1 hour before

the shot or needle procedure. Satisfactory numbing of the skin occurs 1

hour after application, reaches a maximum at 2 to 3 hours (1 hour for

children less than 3 months), and lasts for 1 to 2 hours after removal.

This timing makes it convenient to apply EMLA at home prior to appointment.

Who can use EMLA?

EMLA can be used for most children, including infants at least 37

weeks gestation. However, it should not be used in children with rare

condition of congenital or idiopathic methemoglobinemia, or in infants

under the age of 12 months who are receiving treatment with methemoglobin-inducing

agents. It should also not be used in children with sensitivity to

lidocaine or prilocaine, or any other component of the product. If you have

any questions as to whether or not EMLA is right for your child, please

consult your child's doctor.

Repeated Use

You can use EMLA for repeated procedures in the same place on his

or her skin without the skin becoming permanently numb. The numbing effect

of EMLA goes away completely a few hours after each application, whether

it's been used at the same site or not.

Satisfactory

numbing of the skin occurs 1 hour after application, reaches a maximum at 2

to 3 hours (1 hour for children less than 3 months), and lasts for 1 to 2

hours after removal. This timing makes it convenient to apply EMLA at home

prior to appointment.

Safe to Touch?

Since it takes time for EMLA to work, simply touching the

Anesthetic Disc will not cause the area of touch to become numb, if EMLA is

accidentally smeared on another part of the skin, just wipe it off.

Accidental ingestion of EMLA may be toxic. Call your local

Poison Control Center and your doctor.

If EMLA comes in

contact with your child's eyes, immediately rinse the eye with water; do

not touch or rub the eye. Call your local emergency service or Poison

Control Center and your doctor.

Error! Filename not specified.

In adults, prior

to procedure, squeeze out a dollop of EMLA Cream (1/2 of a 5-g tube)

directly onto the skin. EMLA Cream may be left in place for up to 3 hours

without diminishing its effectiveness. For pediatric patients, apply ONLY

as prescribed by a physician.

Immediately before the procedure (at least 60 minutes

after EMLA Cream has been applied), remove the dressing and cream.

Clean entire area as usual and begin procedure.

Be sure to allow EMLA Cream to remain in a thick layer,

DO NOT rub it in. Keep away from eyes and children.

=================================

LAST ONE....

4.

Also

here's another article about injections with a steroid and lidocaine for

vestibulitis you might be interested in.

Dee

Journal of Lower Genital Tract

Disease

Volume 6 Issue 1 Page 62 - January 2002

Treatment of Vulvar Vestibulitis with Submucous Infiltrations of

Methylprednisolone and

Lidocaine

F Murina, P Tassan, P i, V Bianco

This group from Italy gave subcutaneous injections of 40 mg of

methylprednisolone

acetate and 10 mg of lidocaine cloridrate in 10 ml of

normal saline into the

vulvar vestibule in 22 women with vulvar

vestibulitis. Injections

were divided into equal parts between three

sites, described as 4

o'clock, 8 o'clock, and around the posterior

fourchette. Follow up

occurred monthly for three months, then after six

and nine months.

Fourteen women had 12 months and five women 24 months of follow

up. Fifteen women (68)

responded favorably to treatment, 32 with

complete remission.

Remission of symptoms occurred about 15 days after

treatment. Five patients

relapsed after one year and responded with

immediate remission when

treated with a 0.5 ml infiltration. None

required therapy after

the 12th month.

Comment:

" Vulvar vestibulitis syndrome is difficult for patients and

practitioners with a

myriad of treatments including oceans of lotions

and potions and notions

about what should make this go away.

Long-term antifungal therapies, steroid creams, sex hormone

creams, topical

analgesics, diets, dietary supplements, capsacin, laser,

antidepressants,

anticonvulsants, musculoskeletal therapies, surgeries

of various kinds, and

many other things have been tried as treatments.

This extended case report suggests a good possible therapy that would

be readily

available.>

Here

are some other names of topical anesthetics I added too for what it's

worth. ; )

Benzocaine

· Americaine, Anacaine, Dermacoat, Hurricane, Lagol

Butamben

· Butesin Picrate

Lidocaine

· Dermaflex, Ela-Max, Xylocaine

Pramoxine

· Itch-X, PrameGel, Prax, Tronolane, Tronothane

Tetracaine

· Pontocaine, Viractin

Hope

that's of some help, and apologize for the length.

Hugs

Dee~

; )