We conducted a randomized, double-blind, placebo-controlled trial to evaluate the effectiveness of EMLA cream together with intraperitoneal lidocaine for pain relief in postpartum tubal ligation. In a factorial designed study, 90 postpartum patients were randomly assigned to have 5 g of EMLA or placebo bream applied to the skin in 2 groups of 45 patients and to have intraperitoneal instillation of 20 ml of either 1%, 2% lidocaine or normal saline in 3 groups of 30 patients. A numerical rating pain score (0-10) was used during skin check, skin infiltration and uterine tube manipulation. The pain scores were significantly lover in the EMLA group as compared with the placebo group during the skin forceps check (p < 0.001) and during the local infiltration (p < 0.05). the pain scores were also significantly lover during intraabdominal manipulation in the group using either 1% or 2% intraperitoneal lidocaine as compared with the group using normal saline (p < 0.001), but no difference was found between the groups using 1% and 2% lidocaine.Implication : Five grams of EMLA cream applied to the skin together with 20 ml of 1% lidocaine instilled into the abdominal cavity effectively postpartum tubal sterilization under local anesthesia.