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A multicentre randomized study of single-unit dose package of EMLA patch vs EMLA 5% cream for venepuncture in
P C Chang1, G V Goresky, G O'Connor
1Department of Anaesthesia, Alberta Children's Hospital, Calgary, Canada.
Insights
The Eutectic mixture of local anaesthetics (EMLA) patch is as effective as EMLA cream for reducing venepuncture pain in children. Both methods provided comparable pain relief and local reactions during the procedure.
Area of Science:
- Pediatric Anesthesiology
- Dermatology
- Pain Management
Background:
- Venepuncture in children often causes significant pain and anxiety.
- Effective topical analgesia is crucial for improving pediatric procedural tolerance.
Purpose of the Study:
- To compare the analgesic efficacy, adhesiveness, and local reactions of Eutectic mixture of local anaesthetics (EMLA) patch versus EMLA cream with Tegaderm during pediatric venepuncture.
Main Methods:
- A comparative study involving 178 children aged 3-10 years undergoing venepuncture.
- Application of EMLA patch or EMLA cream with Tegaderm for at least 60 minutes prior to venepuncture.
- Pain assessment using a three-point verbal rating scale by both subject and observer; evaluation of adhesion and local reactions.
Main Results:
- No significant difference in pain reduction between the EMLA patch and EMLA cream groups (95% vs 94% reported no or slight pain).
- Comparable rates of local reactions were observed between the two treatment groups.
- The EMLA patch demonstrated lower adhesion compared to Tegaderm (P < 0.001), without impacting its effectiveness.
Conclusions:
- EMLA patch is equivalent to 5% EMLA cream (2.5 g) in providing cutaneous pain relief for venepuncture in children.
- Both formulations offer effective pain management, making them suitable options for pediatric venepuncture.
- Adhesion differences do not appear to compromise the analgesic performance of the EMLA patch.
Abstract:
Eutectic mixture of local anaesthetics (EMLA) cream with Tegaderm was compared with pre-packaged EMLA patch with regard to analgesic effect, adhesiveness and local reactions during venepuncture in 178 children from three to ten years. One EMLA patch, or half the contents of a 5 g tube of EMLA cream plus Tegaderm was applied to the dorsum of one hand or antecubital fossa for a minimum of 60 min before venepuncture. The subject and observer assessed the degree of pain on a three-point verbal rating scale. The adhesion of the patch vs Tegaderm to the skin and local reactions were recorded. There was no difference between the two groups in pain associated with venepuncture; 95% of the EMLA patch group and 94% of the EMLA cream group reported no or slight pain. There was no difference between the two treatment groups in terms of overall local reactions. The patch was less adhesive (P < 0.001), but this had no apparent influence on its effectiveness. In conclusion, EMLA patch is equivalent to 5% EMLA cream (2.5 g) in cutaneous pain relief when used for venepuncture in children.