Combined use of EMLA cream and Buzzy for peripheral intravenous cannulation in children: a randomized controlled
Marco Persoglia1, Irene Lapucci1, Egidio Barbi1,2
1Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Insights
Combining EMLA cream with the Buzzy device significantly reduced procedural distress in children undergoing intravenous cannulation, as reported by parents. This combination therapy proved effective in managing distress without impacting pain levels.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Child Psychology
Background:
- Peripheral intravenous cannulation in children can cause significant pain and distress.
- This can lead to long-term issues like anxiety and needle phobia.
- Effective strategies are needed to mitigate these adverse effects.
Purpose of the Study:
- To evaluate the efficacy of combining EMLA cream with the Buzzy device compared to EMLA alone.
- To assess the impact on procedural distress and pain during intravenous cannulation in children.
Main Methods:
- A randomized controlled trial was conducted in two Italian tertiary children's hospitals.
- Children aged 4-12 years received either EMLA alone or EMLA plus Buzzy.
- Distress was measured using the Children's Emotional Manifestation Scale (CEMS) by parents; pain was assessed using the Faces Pain Scale-Revised (FPS-R).
Main Results:
- Parent-rated distress was significantly lower in the EMLA plus Buzzy group compared to the EMLA alone group (p=0.001).
- Pain scores and first-attempt success rates were comparable between the two groups.
- No severe adverse events were reported in either group.
Conclusions:
- Combining EMLA cream and the Buzzy device is an effective strategy for reducing parental-reported procedural distress in children.
- This combined approach does not appear to significantly alter pain perception or procedural success rates.
- Further research may explore operator and child-reported outcomes with this combined intervention.
Aim:
Preventing pain and distress during peripheral intravenous cannulation in children is essential to avoid long-term anxiety or needle phobia. This study evaluated whether combining EMLA cream with the Buzzy device is more effective than EMLA alone in reducing procedural distress and pain.
Materials And Methods:
We conducted a randomized controlled trial in two tertiary children's hospitals in Italy (March-October 2023). Children aged 4-12 years requiring intravenous cannulation were randomized to receive either EMLA alone or EMLA plus Buzzy. The primary outcome was distress, assessed by parents using the Children's Emotional Manifestation Scale (CEMS). Secondary outcomes included pain measured with the Faces Pain Scale-Revised (FPS-R) by children, parents, and healthcare operators, operator-rated distress, first-attempt success, and adverse events. Analyses followed an intention-to-treat basis.
Results:
Ninety-four children (median age 8 years) were enrolled: 47 in the EMLA plus Buzzy group and 47 in the EMLA alone group. Parent-rated distress was significantly lower with EMLA plus Buzzy (median CEMS 6, IQR 5-7) than with EMLA alone (9, IQR 7-12; p = 0.001). Pain scores and first-attempt success rates were similar. No severe adverse events occurred.
Conclusion:
Combining EMLA and Buzzy significantly reduced procedural distress perceived by parents without affecting pain scores.
Related Concept Videos
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...