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[EMLA analgesic cream for venopuncture during anesthetic induction in children]
C Ecoffey1, A M Dubousset, F Trinquet
1Département d'Anesthésiologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Insights
EMLA cream, a mixture of prilocaine and lidocaine, effectively provides skin analgesia for pediatric venipuncture. This anesthetic cream is convenient for use in toddlers and children undergoing medical procedures.
Area of Science:
- Pediatric Anesthesiology
- Dermatology
- Pain Management
Background:
- Venipuncture in children can be painful, leading to anxiety and distress.
- Effective pain management is crucial for pediatric procedures.
- EMLA cream (eutectic mixture of local anesthetics) is a topical anesthetic option.
Purpose of the Study:
- To evaluate the efficacy and convenience of EMLA cream for skin analgesia during pediatric venipuncture.
- To assess pain levels in children of different age groups after EMLA cream application.
- To identify any local adverse effects associated with EMLA cream use.
Main Methods:
- Prospective study involving children aged 3 months to 15 years undergoing genital and urinary surgery.
- Children were divided into two groups: ≤5 years and >5 years.
- EMLA cream was applied to the skin, covered with a dressing, and venipuncture performed after approximately 92 minutes.
Main Results:
- EMLA cream application was considered easy or very easy by nursing staff.
- Children ≤5 years reported high pain intensity (CHEOPS scale), while older children reported significant pain on a visual analog scale.
- Local adverse effects like skin paleness and erythema were observed in some patients.
Conclusions:
- EMLA cream offers convenient skin analgesia for venipuncture in pediatric patients.
- Pain relief efficacy may vary by age group.
- Further research may be needed to optimize EMLA cream application for improved pediatric pain management.
Abstract:
A prospective study was designed to assess the quality of skin analgesia provided by the EMLA anaesthetic cream, an eutectic mixture of local anaesthetics (prilocaine and lidocaine). The children, aged 3 months to 15 years, and scheduled for genital and urinary surgery, were allocated to two groups, those aged less than or equal to 5 years (35 +/- 14 months, n = 17), and those aged greater than 5 years (97 +/- 26 months, n = 22). The cream (1.6 +/- 0.6 g) was applied by a nurse in the ward as a thick layer on the area of skin to be anaesthetised (on the dorsum of the hand and at the elbow), and covered by a closed adhesive dressing. This required 2.6 +/- 1.7 min, and was considered to be very easy (72%) or easy (28%). The venepuncture (22 or 20 gauge catheter) was carried out by one of the seven anaesthetists of the paediatric surgical units, 92 +/- 51 min after the cream had been applied. The children aged less than or equal to 5 years complained of pain of intensity 7.5 +/- 2.2 (CHEOPS scale, range 4 to 13) and, for those aged greater than 5 years, 24 +/- 21 on a visual analogic scale (range 0 to 100). Local adverse effects occurred in ten patients (skin paleness, erythema, or both). It was concluded that EMLA cream provides convenient analgesia for venepuncture in toddlers and children.