One of the major disadvantages of the spinal anesthesia is that the patients feel anxiety and pain during the spinal needle puncture. It is aimed to compare the analgesic effects of 5% prilocaine-lidocaine cream with 1 mu g kg(-1) intravenous fentanyl applied before spinal puncture. Seventy-five male patients of ASA I-II, with the age range 20-65 were included and randomly divided into three groups in the study. Forty-five minutes before the spinal needle puncture 2.5 g 5% prilocaine-lidocaine cream was applied on the intervention area of the Group A patients. Ten minutes before the spinal puncture 1 mu g kg(-1) fentanyl intravenous bolus was applied to the Group B patients; but no analgesics or local anesthetics were applied to the Group C patients. The anxiety level of the patients was measured with APAIS-A anxiety score and the sedation level was measured with Ramsay Sedation Scale. The pain felt by the insertion of the spinal needle was assessed with 0-4 range Verbal Rating Scale. Additionally, patient's satisfaction, quality of performance and irritation movement were evaluated. Verbal Rating Scale scores and irritation movements were significantly lower in Group A. Patient's satisfaction was significantly higher in Group A. Quality of performance was significantly higher in Group A than the rest of the groups and in Group B than Group C. As a result, it is concluded that by considering the parameters of analgesic activity, patient's satisfaction, irritation movements and quality of performance; 2.5 g, 5% prilocaine-lidocaine cream is superior to intravenous 1 mu g kg(-1) fentanyl in reducing the spinal puncture pain.