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[Clinical study of EMLA analgesic cream in pediatric locoregional anesthesia]
E Giaufré1, M Le Gal, F Trinquet
1Service d'Anesthésie-Réanimation, Hôpital Saint-Joseph, Marseille.
Insights
EMLA cream offers effective pain relief for pediatric regional blocks, improving patient comfort and cooperation during procedures. This topical anesthetic is well-tolerated, making it a convenient option for children undergoing surgery.
Area of Science:
- Pediatric Anesthesiology
- Dermatology
- Pain Management
Background:
- Regional blocks are crucial for pediatric surgical anesthesia.
- Effective pain management and patient cooperation are vital for successful pediatric regional blocks.
- EMLA cream is a topical anesthetic with potential for pre-procedural analgesia.
Purpose of the Study:
- To assess the efficacy and safety of EMLA cream for analgesia during regional blocks in children.
- To evaluate patient comfort, cooperation, and procedural ease with EMLA cream pre-application.
- To determine the incidence of adverse effects associated with EMLA cream use in pediatric patients.
Main Methods:
- A study involving 46 children undergoing spinal or caudal blocks, divided into three age groups.
- EMLA cream applied topically 2.2 hours prior to the block, with varying doses based on age.
- Assessment of procedural constraints, patient cooperation, pain levels, and local adverse effects.
Main Results:
- The EMLA cream technique was minimally constraining, with good to very good patient cooperation in most cases (34/46).
- Most children experienced little to no pain during the regional block procedure.
- Local adverse effects like erythema and skin paleness occurred in 19/46 patients; overall use was deemed satisfactory or very satisfactory by the investigator (36/46).
Conclusions:
- EMLA cream provides convenient and effective analgesia for regional blocks in toddlers and children.
- The application of EMLA cream is well-tolerated and facilitates patient cooperation, enhancing the regional block procedure.
- EMLA cream is a valuable tool for improving the pediatric regional block experience, reducing pain and anxiety.
Abstract:
The advantage of EMLA cream for regional blocks (spinal or caudal blocks) was assessed in 46 children. The study included three groups: group 1, with 1 to 6 month-old children (n = 11); group 2, with children aged between 6 months and 5 years (n = 21), scheduled for emergency surgery and with full stomach; group 3, with 5 to 10 year-old children (n = 14), who were to have a regional block as an alternative to general anaesthesia. The cream was applied as a thick layer on the area of skin to be anaesthetised and covered by a closed adhesive dressing, approximately 2.2 h before performing the regional block. A dose of 1 to 2 g was used in children of more than 1 year, and 0.5 to 1 g for those of less than 1 year. All the blocks were carried out by the same anaesthetist. The technique was considered as being little (45/46) or not constraining (1/46). Patient cooperation in carrying out the regional block was judged to be good or very good in 34/46 children. Additional sedation was required in 7 children of groups 2 and 3. The block was as easy to carry out as usual in 37/46 children. In all three groups, most children complained of little or no pain. Local adverse effects occurred in 19/46 patients, consisting of erythema (14), skin paleness (4), or both (1). The investigator qualified the use of EMLA cream as satisfactory or very satisfactory in 36/46. It is concluded that EMLA cream provides convenient analgesia for regional blocks in toddlers and children.