Amethocaine vs lidocaine - Prilocaine local anaethetic ointments, for procedural pain in children

Objective: To compare the effect of Amethocaine (Ametop) and Lidocaine-Prilocaine (EMLA), in children with cancer undergoing Port-a-Cath puncture. Study design: A randomized, double-blind, cross over design. Patients: Thirty nine children completed the study: The mean age was 10 years and 4 months and all were treated with various chemotherapy protocols. Methods: Every child received 1g of amethocaine gel for 30 min, preceded by a placebo gel for 30 min or l g of EMLA cream for 60 min, which was checked at 30 min to guarantee blindness. The dressing was removed after 60 min, and the procedure was done within 5-10 min. Children rated the pain using the "faces" visual analogue scale (VAS), scoring from 0 to 5. Parents and attending nurse operators rated the pain on a 10 cm scale VAS. Results: There were no differences in mean VAS scores with amethocaine vs EMLA as rated by the children, parents or nurse operators. No serious side effects were detected with either ointment. Conclusion: Our results indicate that for Port-a-Cath application in children, 30 min of amethocaine gel is clinically equivalent to 60 min of EMLA.