Background: Open trigger digit release in adult is a common hand surgery. Most of the patients considered local anesthetic injection was the most painful step during the procedure. Topical anesthetic drug was not routinely used in the hand surgery. The study on its effectiveness in open trigger digit release has never been studied before. Objective: To evaluate the effectiveness of topical anesthetic drug in patients who underwent open trigger digit release surgery Materials and Methods: This study is a randomized controlled trial to compare pain score and patient satisfaction between topical anesthetic cream (5% lidocaine-prilocaine cream) versus placebo cream, applied approximately 90 minutes prior to local anesthetic injection in open trigger digit release surgery. One hundred participants were enrolled and randomly allocated into two groups between May 2019 and February 2020. Visual analog pain score and satisfaction rate were compared. Results: Most of participants were female with Quinnell grade 2-3. Pain score during needle injection, local anesthetic infiltration, overall pain and satisfaction rate had no statistically significant difference between groups. There was no correlation between duration of topical anesthetic drug application and pain scores. Subgroup analysis did not show significant differences in pain score between genders. No complication was found. Conclusion: The topical anesthetic drug is ineffective to use at the palmar skin of hand and preoperative application on the surgical site is not necessary for open trigger digit release operation.