Analgesic Effects of EMLA Cream and Oral Sucrose During Venipuncture in Preterm Infants

Biran, Valérie; Gourrier, E; Cimerman, Patricia; Walter-Nicolet, E.; Mitanchez, Delphine; Carbajal, Ricardo

doi:10.1542/peds.2010-1287

Cited by 42 publications

(24 citation statements)

References 39 publications

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“…However, oral sucrose 24 % [76] or glucose 30 % [77] in combination with a pacifier seems to be more effective in reducing pain expression during venipuncture than EMLA application. However, the combination of sucrose and EMLA cream revealed a higher analgesic effect than sucrose 24 % alone during venipuncture in preterm infants [78]. Similar effects have been documented for pain relief during percutaneous venous catheter placement (heart rate, respiratory rate) and arterial puncture (behavioral pain score).…”

Section: Topical and Local Anesthesiasupporting

confidence: 54%

Sedation in the Neonatal Intensive Care Unit: International Practice

Allegaert

Anker

2014

Pediatric Sedation Outside of the Operating Room

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Inadequate pain management in neonatal life impairs neurodevelopmental outcome because it alters pain thresholds, pain-or stress-related behavior, and physiological responses later in life. However, there are recently also emerging animal experimental and human epidemiological data on the impact of analgo-sedatives on neuro-apoptosis and impaired neurodevelopmental outcome. As a consequence, the management of neonatal pain is in search of a new balance, and these conflicting observations are the main drivers to tailor our pain management in neonates. Adequate pain management is based on prevention, assessment, and treatment with subsequent reassessment. Issues related to prevention and assessment tools are covered. Non-pharmacological (e.g., complementary interventions like facilitated tucking, nonnutritive sucking) and pharmacological (e.g., acetaminophen, opioids, ketamine, propofol) treatment modalities were reviewed and reflect the increased knowledge on neonatal pain management. Each topic ends with some take-home messages that in part also reflect our opinion on the current status of this topic.

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Section: Topical and Local Anesthesiasupporting

confidence: 54%

Sedation in the Neonatal Intensive Care Unit: International Practice

Allegaert

Anker

2014

Pediatric Sedation Outside of the Operating Room

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“…25 EMLA has not been assessed for pruritus relief in the adult burn population; interestingly, EMLA has also been used for pain relief during venipuncture and vaccination in children. [28][29][30] A pediatric observational study using the Unna boot demonstrated fewer itch symptoms as well as reduced dressing change time, lower cost of dressings, and better appetite, sleep, and play patterns. 22,26 In a pilot study, the administration of loratadine provided subjective relief of itching for all patients.…”

Section: Discussionmentioning

confidence: 99%

Pruritus in Pediatric Burn Survivors

Schneider

Nadler

Herndon

et al. 2015

Journal of Burn Care & Research

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“…[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. 117,118 …”

Section: Topical Anesthetic Agentsmentioning

confidence: 99%

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

Keels¹,

Sethna²,

Watterberg³

et al. 2016

Pediatrics

317

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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Analgesic Effects of EMLA Cream and Oral Sucrose During Venipuncture in Preterm Infants

Abstract: The combination of sucrose and EMLA cream revealed a higher analgesic effect than sucrose alone during venipuncture in these preterm infants.

Cited by 42 publications

References 39 publications

Sedation in the Neonatal Intensive Care Unit: International Practice

Sedation in the Neonatal Intensive Care Unit: International Practice

Pruritus in Pediatric Burn Survivors

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

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