Eutectic mixture of local anesthetics reduces pain during intravenous catheter insertion in the pediatric patient

Abstract

Objective: The objective of this study was to explore the relation between the application of a mixture of lidocaine/prilocaine cream (eutectic mixture of local anesthetics [EMLA]) before intravenous cannula insertion and perceived pain in the pediatric patient.

Design: Double-blind placebo-controlled trial.

Setting: A general inpatient pediatric ward.

Patients: We examined 26 male and 31 female patients between the ages of 4 and 12 years who required intravenous cannula insertion. Intravenous insertion was performed on 57 patients, with 29 patients in the placebo group (mean age, 8.1 years) and 28 in the EMLA group (mean age, 8.0 years).

Interventions: Application of either EMLA cream or placebo 45 minutes before intravenous cannulation.

Outcome measures: Pain was scored by the patients using a 0- to 10-cm visual analogue scale combined with a Faces pain scale as well as visual observation by a nurse. Adverse side effects were recorded in a separate table.

Results: Data collected and the differences between the placebo and treated groups were tested using a Mann-Whitney U test. Those children in the EMLA group (mean pain score, 1.25) experienced less pain than those in the placebo group (mean, 8.39). There was no statistical significance between age, sex, and race.

Conclusions: The authors conclude that a topical preparation of lidocaine/prilocaine significantly reduces children's pain during intravenous cannula insertion when applied to an intact dermal layer of the skin and that this effect occurs within 45 minutes.