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[Combination of Emla cream and nitrous oxide for venous cannulation in children]
K Mjahed1, A Sadraoui, A Benslama
1Département d'anesthésie-réanimation. CHU Ibn Rochd, Casablanca, Maroc.
Insights
Emla cream and nitrous oxide (N2O) effectively reduce pain and anxiety during pediatric venous cannulation. This combination offers better pain management compared to placebo or N2O alone.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Venous cannulation in children can be a painful and anxiety-provoking procedure.
- Effective pain relief and anxiolysis are crucial for pediatric patient care during medical interventions.
Purpose of the Study:
- To evaluate the efficacy of combining Emla cream with nitrous oxide (N2O) for managing pain and anxiety during venous cannulation in children.
- To compare this combination therapy against placebo and N2O alone.
Main Methods:
- A prospective, randomized, double-blind trial involving 75 children (3 months to 5 years) undergoing elective surgery.
- Participants were randomized into three groups: Emla cream + N2O, placebo + N2O, and Emla cream + oxygen.
- Pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), alongside observations of venous puncture conditions and behavior.
Main Results:
- No significant differences were observed in the conditions of venous cannulation across the groups.
- The CHEOPS pain score was significantly lower in the Emla cream + N2O group (7[4-11]) compared to the placebo + N2O group (10[6-13]) and the Emla cream + oxygen group (9[6-12]).
Conclusions:
- The combination of Emla cream and nitrous oxide provides effective analgesia for pediatric venous cannulation.
- This combined approach is successful in alleviating anxiety associated with needle phobia during the procedure.
Objective:
To assess the efficacy of an combination of Emla cream and N2O for venous cannulation in children.
Study Design:
Prospective, randomized, double blind trial.
Patients:
The study included 75 unpremedicated children, aged 3 months to 5 years, ASA physical class I and II, undergoing an elective surgical procedure, randomized into three groups.
Methods:
In group I and III, children received Emla cream one hour before entering the theatre. In group II, children received a placebo. Children of group I and III also inhaled 50 vol% nitrous oxide in oxygen and those of groupe II 100 vol% oxygen, 3 min prior and during venous cannulation. A blinded observer recorded the following items: pain assessment with CHEOPS scoring, conditions of venous puncture and behaviour of children. Heart rate, blood pressure and oxygen saturation were assessed at three timepoints: before, 3 min after facial mask application and following venous cannulation.
Results:
There were non significant differences between the three groups for the conditions of venous cannulation. The CHEOPS score was better in group I (7[4-11]), compared to group II (10[6-13]; P < 0.01) and to group III (9[6-12]; P < 0.01).
Conclusion:
Emla cream combined with nitrous oxide is effective for venous cannulation in providing satisfactory analgesia and in controlling anxiety elicited by the vision of needle.