Preparation: Lidocaine 2.5% and prilocaine 2.5% in a cream. Individual tubes contain 5 g and come with occlusive dressings. Eutectic refers to a gel state that occurs in a mixture of different agents that would not occur with each alone at a given temperature (room temperature for EMLA). A thick layer of cream should be placed over the appropriate area and an occlusive dressing placed to prevent loss.

Indication: Topical anaesthesia to skin, but not for mucous membranes: it will anaesthetize mucous membranes, but its absorption limits the duration of action. Systemic effects are not seen after a single application.

Timing: EMLA takes 40-60 minutes to work effectively and can last up to 5 hours.

Problems with use: If left in place for a long time, vasoconstriction may make cannulation more difficult.

Cautions: If to be used for topical anaesthesia of a large area, then it should not be used in patients with methaemoglobinaemia, since a metabolite of prilocaine can worsen this condition.