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Topical lidocaine in the treatment of partial-thickness burns.

The analgesic properties and systemic absorption of topical lidocaine in the treatment of partial-thickness burns were evaluated by applying a 5% lidocaine cream to the burn wound at a concentration of 1 mg/cm2. The plasma lidocaine level was measured in 24 patients 15, 30, 60, 120, and 240 minutes after application. Systemic analgesics were given 30 minutes before application of the lidocaine cream. The Visual Analog Scale was used to record pain intensity in 30 patients just before and 30 minutes after application of the lidocaine cream. The maximal area treated was 28% total body surface area partial-thickness burn with application of 4.5 gm of lidocaine, resulting in a plasma level of 5.8 micrograms/ml. The plasma lidocaine level was constant during the 4-hour experiment and was associated with a significant decrease in pain. No infectious, allergic, or cardiovascular complications were observed. Our results indicate that topical lidocaine cream offers significant pain relief of long duration without associated systemic side effects.