EMLA cream vs 10% lidocaine cream for attenuating venous cannulation pain – a clinical trial

Abstract

Background: Venous cannulation is a painful procedure that is associated with anxiety, distress and discomfort. But pain is frequently overlooked in adults. Aims and Objective: We compared the efficacy of 5% EMLA cream and 10% lidocaine cream in attenuating pain associated with peripheral venous cannulation. Methods: This prospective, randomized, placebo-controlled trial was conducted in 102 ASA I and II adults scheduled for elective surgery. They were randomly allocated by blind balloting to one of three groups: group E had 1.5 mL of EMLA cream, group L 1.5 mL of 10% lidocaine cream, and group P 1.5 mL KY gel. All cream was applied over a visible vein for 60 min with occlusive dressing. Pain was evaluated using visual analogue scale (VAS) and verbal rating scale (VRS). Results: The mean VAS score was significantly lower with either EMLA cream (2.62±1.76 cm) or 10% lidocaine cream (1.85±1.58 cm) than with placebo (4.78 ±1.88 cm), p<0.001. Most patients who received EMLA cream (76.5%) or 10% lidocaine cream (70.6%) compared with placebo (55.9%) had mild pain during cannulation using VRS. Conclusion: The eutectic mixture of local anesthetic cream and lidocaine cream attenuated pain associated with peripheral venous cannulation to varying degrees.

Reforming the National Health Insurance Fund for better surgical care financing

“…Minimally invasive surgeries should be encouraged as this leads to shorter operating time, shorter hospital stays and fewer complications (16). A paper by Olwadun et al in this issue proposes a way of reducing pain during cannulation procedures (17). Were such innovations with proved patient benefits rewarded, surgeons would incorporate them in care provision.…”

Efek Eutectic Mixture of Local Anesthetics (EMLA) terhadap Nyeri Penyuntikan Jarum Spinal

“…Penelitian menunjukkan bahwa Eutectic mixture of local anesthetics (EMLA) memiliki efek analgesik yang baik dalam pemasangan jalur intravena, pungsi lumbar, prosedur bedah dermatologi dan kosmetik, serta prosedur medis minor lainnya. 2,4,5,[6][7][8][9] Keuntungan EMLA adalah aplikasi yang mudah dan sederhana, sedangkan kerugiannya adalah mula kerja yang cukup lama untuk mencapai efek analgetik yang optimal. Pada penelitian ini dipilih EMLA karena mudah didapat dan diaplikasikan.…”

“…Penggunaan EMLA sebelum penyuntikan jarum spinal telah dilakukan pada penelitian sebelumnya seperti pada tindakan pungsi lumbar dan pasien yang menjalani prosedur brachytherapy dalam anestesi spinal. [6][7][8][9] Teknik anestesi spinal merupakan teknik anestesi yang sering dilakukan dan memberikan banyak keuntungan untuk operasi tubuh bagian bawah. Ketakutan akan nyeri dan kerusakan saraf merupakan 2 faktor utama yang memengaruhi penerimaan pasien untuk dilakukan tindakan anestesi spinal untuk yang pertama kali.…”

“…Faktor-faktor tersebut dapat memengaruhi respons terhadap nyeri saat penyuntikan jarum spinal. Karakteristik subjek kedua kelompok pada penelitian ini tidak berbeda bermakna (p>0,05) sehingga menjelaskan sampel penelitian pada kedua kelompok dianggap homogen dan layak untuk dibandingkan 5,8 Efek EMLA saat penyuntikan jarum spinal dinilai dari skor nyeri menggunakan NPRS. Terdapat perbedaan yang signifikan secara statistik antara kelompok EMLA dan plasebo.…”

Pain Attenuation During Peripheral Venous Catheterisation and Venipuncture Among an African Study Population: A Narrative Review.

“…Topical anaesthetics are agents that bring about topical anaesthesia, or a reversible loss of sensation in a circumscribed area of the skin or mucous membranes, by reversibly blocking the conduction of nerve impulses at free nerve endings [9]. Some of the topical anaesthetic agents that have been employed to achieve topical anaesthesia before peripheral venous cannulation include the Eutectic Mixture of Local Anaesthetics (5% EMLA): a mixture of 2.5% Lidocaine and 2.5% Prilocaine in an emulsion base; 4% Amethocaine gel, 10% Lidocaine, coolants such as ethyl chloride, alkane mixtures, and fluorohydrocarbons [10][11][12][13]. Although reviews [7,14], evaluating the reduction in PVC insertion/venipuncture pain with the use of topical anaesthetic agents compared to placebo, had been conducted globally, none had been undertaken in Africa.…”