A Randomized Trial of Eutectic Mixture of Local Anesthetics During Lumbar Puncture in Newborns

Kaur, Gurvinder; Gupta, Puneet; Kumar, Ashok

doi:10.1001/archpedi.157.11.1065

Cited by 90 publications

(49 citation statements)

References 17 publications

(9 reference statements)

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“…These agents have been found to decrease measures of pain during venipuncture, percutaneous central venous catheter insertion, and peripheral arterial puncture. [112][113][114] EMLA did not decrease pain-related measures during heel lance 113 but may decrease pain measures during lumbar puncture, 115 particularly if the patient is concurrently provided with oral sucrose or glucose solution. 116 Concerns related to the use of topical anesthetics include methemaglobinemia, prolonged application times to allow absorption for optimal effectiveness, local skin irritation, and toxicity, especially in preterm infants.…”

Section: Topical Anesthetic Agentsmentioning

confidence: 99%

Prevention and Management of Procedural Pain in the Neonate: An Update

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

306

171

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The prevention of pain in neonates should be the goal of all pediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor, yet painful procedures. Therefore, every health care facility caring for neonates should implement (1) a pain-prevention program that includes strategies for minimizing the number of painful procedures performed and (2) a pain assessment and management plan that includes routine assessment of pain, pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and measures for minimizing pain associated with surgery and other major procedures.

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Section: Topical Anesthetic Agentsmentioning

confidence: 99%

Prevention and Management of Procedural Pain in the Neonate: An Update

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

306

171

View full text Add to dashboard Cite

show abstract

“…163,164 Available evidence supports the use of local and topical anesthetic for lumbar puncture in neonates. 165,166 Protocols can allow for the timely placement of topical anesthetic, or injected buffered lidocaine can be used at the site of needle insertion before the procedure. Concerns over the increased difficulty of lumbar puncture after local anesthetic use have proved to be unfounded, and one study even demonstrated improved success with the use of topical anesthetic.…”

Section: Controlling Pain Related To Needle Sticks and Other Minor Prmentioning

confidence: 99%

Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems

Zempsky¹,

Cravero²,

Shaw³

et al. 2012

Pediatrics

284

179

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Control of pain and stress for children is a vital component of emergency medical care. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child' s and family' s reaction to current and future medical care. A systematic approach to pain management and anxiolysis, including staff education and protocol development, can provide comfort to children in the emergency setting and improve staff and family satisfaction. Pediatrics 2012;130:e1391-e1405 BACKGROUND A systematic approach to pain management is required to ensure relief of pain and anxiety for children who enter into the emergency medical system, which includes all emergency medical services (EMS) agencies, interfacility critical care transport teams, and the emergency department (ED). 1 The administration of appropriate analgesia in children varies by age as well as by training of the ED team (which includes physicians, nurses, physician assistants, and nurse practitioners), however, and still lags behind analgesia provided for adults in similar situations. 2 Furthermore, neonates are at highest risk of receiving inadequate analgesia. 3,4 Encouragingly, improvements in the recognition and treatment of pain in children have led to changes in the approach to pain management for acutely ill and injured pediatric patients. 5 Studies have shown an increase in opiate use in children with fractures. [6][7][8] Recent advances in the approach and support for pediatric analgesia and sedation, as well as new products and devices, have improved the overall climate of the ED for patients and families in search of the "ouchless" ED. 5,9 Increased parental education regarding pain and sedation, physician comfort and desire to enhance patient satisfaction, and a quest to satisfy accreditation regulations have appropriately driven this effort. System-wide approaches for pain management awareness and strategies work best if they are woven into the fabric of the emergency medical system through education and protocol development. The purpose of this report was to provide information to optimize the comfort and minimize the distress of children and families as they are cared for in the emergency setting.

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“…Similar to the study findings, Taddio [36] illustrated that, when performing venipuncture, it is recommended that clinicians use topical analgesic, as it reduces pain. Further to Kaur [42] stated that EMLA or its composition should also be used for analgesia with lumbar punctures, as it reduced heart rate variability, facial grimacing, and oxygen desaturations when compared to placebo. Yuhico [30] explained that the use of topical local anaesthetics provide analgesia by blocking nociceptive transmission in nerve cells.…”

Section: Discussionmentioning

confidence: 99%