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

Am J Surg. 2011 Dec;202(6):707-11; discussion 711-2. doi: 10.1016/j.amjsurg.2011.06.040. Epub 2011 Oct 21.


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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anesthesia, Local / methods*
  • Anesthetics, Combined / administration & dosage
  • Anesthetics, Local / administration & dosage*
  • Breast Neoplasms / secondary
  • Breast Neoplasms / surgery*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Lidocaine / administration & dosage
  • Lymphatic Metastasis
  • Mastectomy
  • Middle Aged
  • Nipples
  • Ointments
  • Pain / diagnosis
  • Pain / drug therapy*
  • Pain Measurement
  • Prilocaine / administration & dosage
  • Prospective Studies
  • Sentinel Lymph Node Biopsy / methods*
  • Treatment Outcome


  • Anesthetics, Combined
  • Anesthetics, Local
  • Ointments
  • Prilocaine
  • Lidocaine