Analgesic effects of local anesthetic cream in cryotherapy for warts: a meta-analysis of randomized trials

Background and objectiveLocal anesthetic cream (LAC) has been used for analgesia in various procedures. However, the analgesic effect of LAC in cryotherapy for warts is unclear. We aimed to evaluate the effects of LAC in cryotherapy for warts. Material and methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) on the effects of LAC in cryotherapy for warts. We searched MEDLINE, CENTRAL, and EMBASE on 31 March 2017 for relevant RCTs. Two authors independently selected trials, assessed risk of bias, and extracted data. Disagreement was resolved by discussion with a third author. ResultsWe included three RCTs with 228 participants. Two included RCTs had a high risk of reporting bias, with one having a high risk of other bias as well. Use of LAC decreased the pain associated with cryotherapy for warts on the hardened skin of children (visual analogue scale, mean difference -20.80, 95% confidence interval -40.71 to -0.89), but not in adults or on the nonhardened skin of either adults or children. ConclusionsThe available evidence does not support the routine use of LAC applied for 60min in cryotherapy for warts.