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EMLA patch for intravenous cannulation in adult surgical outpatients
H Vaghadia1, O A al-Ahdal, K Nevin
1Department of Anaesthesia, University of British Columbia, Vancouver, Canada. hvaghadi@vanhosp.bc.ca
Purpose:
The purpose of this study was to evaluate the effectiveness of a single-unit-dose package of the EMLA Patch for dermal analgesia during intravenous cannulation in adult, outpatients and in preventing vaso-vagal side effects.
Methods:
After giving consent, 51 ASA I-III adult outpatients participated in a randomized, double-blind, placebo-controlled, parallel-group trial to receive either an EMLA or placebo patch applied to the intravenous cannula site for 60 to 90 min. Following cannula insertion, patients and investigators rated the pain using a 100 mm VAS ruler. The incidence and severity of vaso-vagal responses, local skin reactions, and willingness to pay for the patch were also evaluated.
Results:
The median VAS pain score by patient assessment in the EMLA patch group was lower (8 mm; range: 0-92) than in the placebo group (25 mm; range: 0-98, P < 0.05). The median VAS pain score by investigator assessment was also lower in the EMLA patch group (15 mm; range 1-79) than in the placebo group (23 mm; range 3-81, P < 0.05). There was a notable difference in the number of vaso-vagal reactions (17 placebo vs 4 EMLA, P < 0.05). Eighty-eight percent of patients who received the EMLA patch would be willing to pay for the patch in the future compared with 69% of the placebo patch patients.
Conclusion:
This study showed that the EMLA patch, applied for 60-90 min before venous cannulation reduced the pain of venepuncture and vaso-vagal side effects in adult outpatients.