Site-specific skin reactions to amethocaine

To identify the incidence of children who have local reactions to amethocaine and whether site and age are important factors in the occurrence of local reactions.

A within group (paired) comparison study. Children attending an outpatient department for venepuncture as part of their normal treatment had amethocaine applied to the elbow and the dorsum of the hand.

Seventy-seven children took part in the study of whom 42 (55 per cent) had an urticarial reaction. All 42 children with an urticarial reaction experienced the reaction at the elbow, four of these children also had a reaction at the dorsum of the hand. There was an association between age and reaction with the frequency of reaction greater in younger children (p=0.0002).

There is an increased frequency of urticarial reaction when amethocaine is used at the elbow compared with the dorsum of the hand. Younger children are at an increased risk of experiencing a reaction.