Topical anaesthetics for XXXX : a systematic review and meta-analysis.

@entity1 @entity1340 @entity903 @entity7855 @entity23 @entity3303 @entity2754
UNASSIGNED: Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for @entity2754 ( @entity2754 ). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. The purpose of this systematic review was to evaluate the evidence from @entity23 ( @entity23 ) for topical anaesthetics in the management of @entity2754 . Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT). Methodological quality of @entity23 was assessed. IELT and other outcomes were pooled across @entity23 in a meta-analysis. Between-trial heterogeneity was assessed. Nine @entity23 were included. Seven were of unclear methodological quality. Pooled evidence (two @entity23 , 43 @entity1 ) suggests that EMLA is significantly more effective than placebo at increasing IELT (P < 0.00001). Individual RCT evidence also suggests that Topical Eutectic-like Mixture for @entity2754 (TEMPE) spray and @entity3303 gel are both significantly more effective than placebo (P = 0.003; P < 0.00001); and @entity3303 gel is significantly more effective than @entity7855 or @entity903 (P = 0.01; P = 0.0001). TEMPE spray is associated with significantly more adverse events than placebo (P = 0.003). More systemic adverse events are reported with @entity1340 , @entity7855 and @entity903 than with @entity3303 gel. Diverse methods of assessing sexual satisfaction and ejaculatory control with topical anaesthetics are reported and evidence is conflicting. Topical anaesthetics appear more effective than placebo, @entity903 and @entity7855 at increasing IELT in @entity1 with @entity2754 . However, the methodological quality of the existing RCT evidence base is uncertain.
