Spinal anesthesia is commonly used for surgeries of the lower limbs, pelvis and abdomen. The insertion of the spinal needle can cause discomfort and anxiety in many patients despite the overall good tolerance of the procedure. To reduce the pain of needle puncture, topical local anesthetics can be applied to the skin before spinal anesthesia. 

Eutectic Mixture of Local Anaesthetic cream containing 2.5 percent lignocaine and 2.5 percent prilocaine is widely used for skin anesthesia in pediatric venipuncture and lumbar puncture. Lignocaine patch 5 percent has been shown to reduce pain in conditions such as post herpetic neuralgia and painful diabetic neuropathy and is also effective in providing local analgesia. 

This randomized controlled study aims to compare the effectiveness of EMLA cream and 5 percent lignocaine patch in alleviating pain during spinal needle insertion. Ninety adult patients undergoing elective surgery under spinal anesthesia will be randomly allocated into two groups to receive either EMLA cream or lignocaine patch at the puncture site prior to the procedure. Pain during spinal needle insertion will be assessed using the Visual Analogue Scale. The primary outcome is the difference in pain scores between the two groups and secondary outcomes include ease of needle insertion and patient satisfaction. The study will be conducted at Sapthagiri Institute of Medical Sciences and Research Centre Bangalore.