Assessing pain and analgesia with a lidocaine-prilocaine emulsion in infants and toddlers during venipuncture

TY - JOUR

T1 - Assessing pain and analgesia with a lidocaine-prilocaine emulsion in infants and toddlers during venipuncture

AU - Robieux, Isabelle

AU - Kumar, Ram

AU - Radhakrishnan, Shyam

AU - Koren, Gldeon

N1 - Funding Information: Thisprotocol was approved by the hospital's committee of human experimentation, and consent was obtained from all parents. Forty-one chronically ill infants and toddlers between 3 and 36 months of age were studied during hospitalization (32 patients) or when attending an outpatient clinic (nine). All of them had had previous venipunctures, Supported by Astra Pharmaceuticals, Etobicoke, Ontario, and the Foundation for Medical Research, Paris, France (Dr. Robieux). Submitted for publication Dec. 5, 1990; accepted Jan. 18, 1991. Reprint requests: G. Koren, MD, Division of Clinical Pharmacology, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. *Career Scientist of Ontario Ministry of Health. 9/26/28092 they all had a normal level of consciousness, and none had received sedation or opioid analgesics during the previous weeks. The EMLA preparation is a water emulsion of lidocaine and prilocaine; 1 gm of cream contains 25 mg of both local anesthetics. The placebo cream had the same odor, appearance, and packaging. The double-blind order of administration was randomized. A standardized amount of cream (2 gm) was applied on the intended site of venipuncture at least 45 minutes before the procedure, and the cream was covered by a plastic adhesive film. Subsequently the cream was wiped off, and the venipuncture was carried out according to the usual procedure. Because local anesthetics have been reported to cause methemoglobinemia in infants,7, 8 methemoglobin levels were measured when sufficient blood, obtained for routine tests, was available. One investigator (I.R.) observed the child's behavior before and during the puncture. Pain was scored according to a behavioral pain scale adapted from the Children's Hospital of

PY - 1991/6

Y1 - 1991/6

UR - http://www.scopus.com/inward/record.url?scp=0025762855&partnerID=8YFLogxK

U2 - 10.1016/S0022-3476(05)82220-6

DO - 10.1016/S0022-3476(05)82220-6

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C2 - 2040936

AN - SCOPUS:0025762855

SN - 0022-3476

VL - 118

SP - 971

EP - 973

JO - Journal of Pediatrics

JF - Journal of Pediatrics

IS - 6

ER -