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Drug and Therapeutics Bulletin Apr 2017Although premature ejaculation is the most common ejaculation problem, it is poorly understood and currently has no standard definition. Typically, it involves reduced... (Review)
Review
Although premature ejaculation is the most common ejaculation problem, it is poorly understood and currently has no standard definition. Typically, it involves reduced time to ejaculation, inability to control or delay ejaculation and associated distress. Treatments that have been assessed include psychosexual counselling, antidepressants (e.g. selective serotonin reuptake inhibitors), phosphodiesterase type-5 inhibitors, tramadol and topical anaesthetic agents (e.g. lidocaine/prilocaine cream). A new formulation (cutaneous spray) of lidocaine/prilocaine (Fortacin-Plethora Solutions Ltd.) was launched in the UK in November 2016 for the treatment of primary premature ejaculation. Here, we consider the evidence for lidocaine/prilocaine spray and whether it has a role in the treatment of premature ejaculation.
Topics: Administration, Cutaneous; Anesthetics, Local; Contraindications; Drug Combinations; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Premature Ejaculation; Prilocaine
PubMed: 28408390
DOI: 10.1136/dtb.2017.4.0469 -
Anaesthesia, Critical Care & Pain... Dec 2016Transient neurologic symptoms (TNS) led to the abandonment of intrathecal lidocaine. We reviewed the published literature for information about the duration of action... (Review)
Review
Transient neurologic symptoms (TNS) led to the abandonment of intrathecal lidocaine. We reviewed the published literature for information about the duration of action and side effects of intrathecal prilocaine, which has been recently reintroduced in Europe. Medline and EMBASE databases were searched for the time period from 1966 to 2015. Fourteen prospective and one retrospective study were retrieved. The duration of the surgical block can be adjusted using doses between 40 and 80mg. Hyperbaric prilocaine in doses as low as 10mg can be used for perianal procedures. Four cases of TNS in 486 patients were reported in prospective studies, and none in 5000 cases in a retrospective data set. Spinal prilocaine appears to be safe and reliable for day case anesthesia. However, as chloroprocaine has a shorter duration and a lower risk of TNS and urinary retention, the indications for prilocaine remain to be defined.
Topics: Ambulatory Surgical Procedures; Anesthesia, Spinal; Anesthetics, Local; Humans; Prilocaine
PubMed: 27352633
DOI: 10.1016/j.accpm.2016.03.005 -
The Cochrane Database of Systematic... Apr 2015The authors have requested this review to be withdrawn. The reason is the intervention, lidocaine‐prilocaine cream for analgesia during neonatal circumcision, is... (Review)
Review
The authors have requested this review to be withdrawn. The reason is the intervention, lidocaine‐prilocaine cream for analgesia during neonatal circumcision, is covered in the Cochrane Review of "Pain relief for neonatal circumcision" (Brady‐Fryer 2004). The editorial group responsible for this previously published document have withdrawn it from publication.
Topics: Anesthetics, Local; Circumcision, Male; Humans; Infant, Newborn; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Prilocaine
PubMed: 25840001
DOI: 10.1002/14651858.CD000496.pub2 -
Drugs Jul 1993Eutectic lidocaine/prilocaine cream 5% is a eutectic mixture of the local anaesthetics lidocaine (lignocaine) 25 mg/g and prilocaine 25 mg/g that provides dermal... (Review)
Review
Eutectic lidocaine/prilocaine cream 5% is a eutectic mixture of the local anaesthetics lidocaine (lignocaine) 25 mg/g and prilocaine 25 mg/g that provides dermal anaesthesia/analgesia following topical application. The principal indication in which eutectic lidocaine/prilocaine cream has been studied is the management of pain associated with venipuncture or intravenous cannulation, where significantly greater pain relief than placebo, with equivalent efficacy to ethyl chloride spray and lidocaine infiltration, has been demonstrated. In dermatological surgery, eutectic lidocaine/prilocaine cream offers effective pain relief in children undergoing curettage of molluscum contagiosum lesions, and in adults undergoing split-skin graft harvesting. Particular benefit has also been shown with use of eutectic lidocaine/prilocaine cream in association with treatment of condylomata acuminata in both men and women, and it appears to provide a useful alternative to lidocaine infiltration in this context. Further research in such indications as paediatric lumbar puncture, minor otological surgery, and minor gynaecological, urological and andrological procedures is likely to further broaden the profile of clinical use for eutectic lidocaine/prilocaine cream. Eutectic lidocaine/prilocaine cream has a very favourable tolerability profile, transient and mild skin blanching and erythema being the most frequent adverse events to occur in association with its application to skin. The potential for inducing methaemoglobinaemia, attributed to a metabolite of the prilocaine component of the formulation, prohibits its use in infants younger than 6 months. In summary, eutectic lidocaine/prilocaine cream is a novel formulation of local anaesthetics that has proven to be effective and well-tolerated in the relief of pain associated with various minor interventions in adults and children.
Topics: Anesthetics, Local; Animals; Drug Combinations; Drug Evaluation; Drug Tolerance; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Ointments; Pain; Prilocaine
PubMed: 7691503
DOI: 10.2165/00003495-199346010-00008 -
The Cochrane Database of Systematic... 2000Neonates routinely undergo tissue-damaging interventions as part of medical treatment. The skin is the site of noxious stimulation for many procedures, including... (Review)
Review
BACKGROUND
Neonates routinely undergo tissue-damaging interventions as part of medical treatment. The skin is the site of noxious stimulation for many procedures, including circumcision. EMLA (eutectic mixture of local anesthetics) penetrates intact skin and has the potential to reduce pain associated with circumcision.
OBJECTIVES
To determine the effectiveness of EMLA compared to placebo or no treatment as an analgesic for circumcision in male newborns.
SEARCH STRATEGY
The guidelines of the Cochrane Neonatal Review Group were followed. No language restrictions were applied. Three reviewers (AT, KO, AO) agreed through a consensus process on the inclusion of a specific study.
SELECTION CRITERIA
Randomized controlled trials assessing the efficacy/effectiveness of EMLA to prevent circumcision associated pain. Behavioral and physiological outcome data were accepted for efficacy/effectiveness.
DATA COLLECTION AND ANALYSIS
Data abstracted from each report included gestational age at birth, timing and dosage regimen of EMLA, control group treatment and outcomes. Abstracted data were verified by the three investigators (AT, KO, AO).
MAIN RESULTS
During the different stages of the surgical procedure for circumcision, the increase in heart rate was 12 - 27 beats per minute less for the EMLA group compared to placebo. In a single study, neonates treated with EMLA showed a higher oxygen saturation. Although the data from the three studies could not be combined, crying during circumcision was reported as less in the EMLA treated groups. In two studies, facial action was lower in the EMLA treated groups compared to placebo.
REVIEWER'S CONCLUSIONS
EMLA reduces pain response during circumcision in newborn male infants. Other potentially more effective forms of analgesia for circumcision (such as dorsal penile nerve block, ring block) should be subjected to systematic reviews.
Topics: Anesthetics, Local; Circumcision, Male; Humans; Infant, Newborn; Lidocaine; Lidocaine, Prilocaine Drug Combination; Male; Ointments; Prilocaine
PubMed: 10796371
DOI: 10.1002/14651858.CD000496 -
Anaesthesia Jan 1978
Topics: Anesthesia, Spinal; Humans; Prilocaine
PubMed: 626344
DOI: 10.1111/j.1365-2044.1978.tb08292.x -
Australian Dental Journal Feb 1985
Topics: Anesthesia, Dental; Dental Care; Female; Humans; Pregnancy; Prilocaine
PubMed: 3861158
DOI: 10.1111/j.1834-7819.1985.tb05838.x -
MMWR. Morbidity and Mortality Weekly... Sep 1994Methemoglobinemia is an uncommon disorder in which hemoglobin is not oxidized and not capable of binding oxygen. This condition may be associated with exposure to...
Methemoglobinemia is an uncommon disorder in which hemoglobin is not oxidized and not capable of binding oxygen. This condition may be associated with exposure to nitrate-contaminated drinking water, aniline dyes, and amide-containing medications. Ortho-toluidine, a metabolite of the anesthetic prilocaine, also can induce this condition (1). During March-August 1993, three Wisconsin women treated by the same oral surgeon developed methemoglobinemia after being injected with a prilocaine-based local anesthetic. The surgeon notified the Division of Health, Wisconsin Department of Health and Social Services, of these cases 1 week after the third case occurred. This report summarizes the case investigations.
Topics: Adolescent; Adult; Female; Humans; Methemoglobinemia; Prilocaine; Surgery, Oral; Wisconsin
PubMed: 8072476
DOI: No ID Found -
Handchirurgie, Mikrochirurgie,... Aug 2021Aetiologically, prilocaine-induced methaemoglobinaemia is a rare form of acquired methaemoglobinaemia, which occurs rarely in the first place. The following report...
Aetiologically, prilocaine-induced methaemoglobinaemia is a rare form of acquired methaemoglobinaemia, which occurs rarely in the first place. The following report highlights a potentially dangerous complication arising after application of prilocaine during liposuction.A young female visited the Accident and Emergency Department following a pre-syncopal fall. As a consequence of her fall, she experienced debilitating wrist pain and exhibited a laceration on her chin. She had undergone liposuction of the lower extremity as an outpatient approximately 12 hours earlier and received regional anaesthesia in the process. A large volume of an anaesthetic solution containing prilocaine had been injected into the tissue.The patient was normotensive and slightly tachycardic and had oxygen saturations of 90 % on room air. She was cyanotic and her lips were pale. Initial arterial blood gas analysis showed a methaemoglobin fraction, which was increased significantly to 10.9 %. Conventional radiography confirmed the presence of a minimally dislocated distal radius fracture. Following subsequent oxygen therapy over a four-hour period, the patient's methaemoglobin level dropped to 6 %, her lip cyanosis abated and her vital parameters stabilised. The laceration of her chin was sutured and her wrist immobilised in a split plaster brace. After a 12-hour hospital stay, the patient was discharged. At her six-week follow-up appointment, the fracture had healed and both the functional and cosmetic aspects of her chin wound were adequate. We hope that this report draws the attention of emergency care personnel to the possible diagnosis of prilocaine-induced methaemoglobinaemia after liposuction and encourages more general discussions around the use of prilocaine.
Topics: Female; Humans; Lipectomy; Methemoglobinemia; Prilocaine
PubMed: 33862646
DOI: 10.1055/a-1382-1628 -
International Journal of Impotence... Jun 2023A eutectic mixture of prilocaine/lidocaine spray (Fortacin™, Recordati, Milan, Italy) has been approved for the management of patients affected by life-long premature... (Randomized Controlled Trial)
Randomized Controlled Trial
A eutectic mixture of prilocaine/lidocaine spray (Fortacin™, Recordati, Milan, Italy) has been approved for the management of patients affected by life-long premature ejaculation (PE), but to date, there is a lack of dose- or time-finding studies in the literature that indicate the best method of intake to optimize treatment outcomes. In this multicentre, randomized, two-phase study, we aimed to compare, in terms of treatment effectiveness (primary objective) and safety (secondary objective), different treatment regimens (various doses and times of drug delivery) of Fortacin™ in 91 patients affected with lifelong PE who were recruited at four different centres and randomized (1:1:1 ratio) into three different groups. The study included two phases: during the first phase (focused on time-finding), the same drug dose (three sprays) was taken at different intervals before intercourse (5, 15, 30 min). In the second phase (focused on dose finding), different drug doses (1, 3, 5 sprays) were taken at the same interval before intercourse (5 min). The main outcome measure instruments were self-measured intravaginal ejaculation latency time (sm-IELT), the premature ejaculation diagnostic tool (PEDT), and the International Index of Erectile Function-5 (IIEF-5). Furthermore, patients were asked to report any side effects that appeared during the study period. Our main study findings showed that the treatment regimen with three sprays of Fortacin™ administered 5 min before sexual intercourse showed the best results in terms of ejaculation time and control (Phase I, IELT 221 ± 3.4, PEDT 7.7 ± 0.3; Phase II, IELT 213 ± 4.9, PEDT 7.8 ± 0.4) with a safety profile that was identical to other treatment regimens. Based on these data, patients who are prescribed Fortacin™ should stick to this regimen to optimize treatment results.
Topics: Male; Humans; Premature Ejaculation; Lidocaine; Prilocaine; Ejaculation; Coitus
PubMed: 35314817
DOI: 10.1038/s41443-022-00554-8