title: Trial of a topically administered local anesthetic (EMLA cream) for pain relief during central venous port accesses in children with cancer.
abstract: Procedure-related pain is a significant problem for many children receiving cytotoxic chemotherapy. In an effort to lessen this toxicity, we studied the efficacy and safety of administering topical local anesthesia using EMLA cream in 47 evaluable children with cancer undergoing implanted central venous port injections. Children (< 21 years old) scheduled to undergo repeated venous access procedures were selected for study. A placebo-controlled, randomized, double-blind, crossover study design was utilized. Statistically significant decreases in pain intensity scores (P < 0.002) were recorded by both children and investigators during the use of EMLA cream as compared with placebo. There was a good correlation between pain scores recorded by both patients and health care providers using both visual analog scales and categorized pain measurement tools. The topical application of EMLA cream 5% provides highly effective superficial anesthesia, and promises to be extremely useful for pain relief during percutaneous access procedures in cancer patients.
authors.affiliation: Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: A W
authors.initials: AW
authors.lastname: Miser
authors.forename: T S
authors.initials: TS
authors.lastname: Goh
authors.forename: A M
authors.initials: AM
authors.lastname: Dose
authors.forename: J R
authors.initials: JR
authors.lastname: O'Fallon
authors.forename: R D
authors.initials: RD
authors.lastname: Niedringhaus
authors.forename: D L
authors.initials: DL
authors.lastname: Betcher
authors.forename: P
authors.initials: P
authors.lastname: Simmons
authors.forename: D J
authors.initials: DJ
authors.lastname: MacKellar
authors.forename: M
authors.initials: M
authors.lastname: Arnold
authors.forename: C L
authors.initials: CL
authors.lastname: Loprinzi
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009824:Ointments; D010146:Pain / Q000517:prevention & control*; D011318:Prilocaine / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D000970:Antineoplastic Agents; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine