Utilisation de la creme EMLA® chez la nouveau-né à terme et prématuré. Étude d'efficacité et de tolérance

Gourrier, E; Karoubi, Philippe; Hanache, A El; Merbouche, S.; Mouchnino, G; Dhabhi, S; Leraillez, J

doi:10.1016/0929-693x(96)81278-4

Cited by 39 publications

(14 citation statements)

References 6 publications

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“…In the study by Gourrier et al 16 (described above), the frequency of low pain scores when arterial stabs were administered was 41% compared with 12.5% in the control group (P Ͻ .05).…”

Section: Nonrandomized Controlled Studymentioning

confidence: 90%

“…Application times of Ͼ90 minutes were more efficacious than shorter duration times (P Ͻ .001). 16 Unpublished data obtained by the investigators revealed a mean (ϮSD) behavioral pain score of 2.43 (0.46) in the EMLA-treated group (n ϭ 51) compared with 3.58 (0.82) in the control group (n ϭ 12) (P Ͻ .05). Infant HR was analyzed in 49 infants: 39 were treated with EMLA.…”

Section: Nonrandomized Controlled Studymentioning

confidence: 97%

“…[5][6][7][8][9][10][11][12][13][14][15][16][17] Two studies were excluded; 1 because an experimental procedure was used to measure pain threshold, 5 and another because it did not include a control/no treatment group. 6 Thus, 11 studies were used for the analysis.…”

Section: Efficacy Studiesmentioning

confidence: 99%

“…Two studies that included data from both neonates and older infants were included. 13,16 The dose of EMLA used was 0.5 to 2 g in 9 studies, and was not specified in two studies. The duration of application ranged from 10 minutes to 3 hours.…”

Section: Efficacy Studiesmentioning

confidence: 99%

“…Gourrier et al 16 used a cohort design to evaluate the effectiveness of EMLA for venous and arterial puncture in preterm neonates aged 1 to 64 days (Table 1). Neonates Ն2 kg received one quarter of a tube of EMLA (equivalent to Ϸ0.5 g); neonates Ͻ2 kg received less, although the exact dose was not specified.…”

Section: Nonrandomized Controlled Studymentioning

confidence: 99%

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A Systematic Review of Lidocaine-Prilocaine Cream (EMLA) in the Treatment of Acute Pain in Neonates

et al. 1998

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ABSTRACT. Objective. Neonates routinely undergo painful cutaneous procedures as part of their medical treatment. Lidocaine-prilocaine 5% cream (EMLA) is a topical anesthetic that may be useful for diminishing the pain from these procedures. EMLA is routinely used in children and adults. There is substantial apprehension about its use in neonates because of concerns that it may cause methemoglobinemia. The objective of this review was to determine the efficacy and safety of EMLA as an analgesic for procedural pain treatment in neonates and provide evidence-based recommendations for clinical practice.Methods. Systematic review techniques were used. Studies were identified using manual and computeraided searches (Medline, EMBASE, Reference Update, personal files, scientific meeting proceedings). Behavioral (eg, facial action, crying) and physiologic (eg, heart rate, oxygen saturation, blood pressure, respiratory rate) outcome data from prospective nonrandomized controlled studies and randomized controlled trials in fullterm and preterm neonates were accepted for inclusion to establish efficacy of EMLA. The risk of methemoglobinemia (defined as methemoglobin concentration >5% and requiring medical intervention) was estimated from all prospective studies.Results. Eleven studies of the efficacy of EMLA were included in the analysis. Infant gestational age at the time of delivery ranged from 26 weeks to full-term. Two studies included data from both neonates and older infants. The following procedures were studied: circumcision (n ‫؍‬ 3), heel lancing (n ‫؍‬ 4), venipuncture (n ‫؍‬ 1), venipuncture and arterial puncture (n ‫؍‬ 1), lumbar puncture (n ‫؍‬ 1), and percutaneous venous catheter placement (n ‫؍‬ 1). Nine studies were randomized controlled trials. The total sample size for each study ranged from 13 to 110 neonates. The dose of EMLA used was 0.5 g to 2 g in 9 studies, and was not specified in the others. The duration of application ranged from 10 minutes to 3 hours. The three studies that investigated the efficacy of EMLA for decreasing the pain of circumcision used a randomized controlled trial design. All of them demonstrated significantly reduced crying time during the procedure in the infants in the EMLA group compared with the infants in the control group. Facial grimacing, assessed in two of the studies, was also significantly lower in the EMLA group. Using meta-analytic techniques, the heart rate outcome data for two studies was summarized. Increases in heart rate compared with baseline values were 12 to 27 beats per minute less for the EMLA group than in the placebo group during various stages of the surgical procedure. Three studies that investigated the pain from heel lancing were randomized controlled trials; the other was a nonrandomized controlled study. None demonstrated a significant benefit of EMLA for any of the outcome measures used to assess pain (ie, behavioral pain scores, infant crying, heart rate, blood pressure, respiratory rate, oxygenation parameters). One randomized controlled study ...

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“…In the study by Gourrier et al 16 (described above), the frequency of low pain scores when arterial stabs were administered was 41% compared with 12.5% in the control group (P Ͻ .05).…”

Section: Nonrandomized Controlled Studymentioning

confidence: 90%

Section: Nonrandomized Controlled Studymentioning

confidence: 97%