Improved application of Lidocaine/Prilocaine cream in children. A randomized and prospectively controlled study of two application regimes.
Intravenous cannulation in children aged 6-12 years is less painful after a 90-min application of a Lidocaine/ Prilocaine cream followed by a 30-min interval without cream, than cannulation immediately after a 60-min application.


BACKGROUND
Sixty-min application of an eutectic mixture of 25 mg g(-1) Lidocaine and 25 mg g(-1) Prilocaine cream is widely used in both adults and children to alleviate pain related to intravenous cannulation. However, studies have shown that this is not the optimal procedure in adults. Inspired by the results from these studies, the aim of the present study was to find an improved application regime for children.


METHODS
In this prospective, randomized, and single-blind study 60 Caucasian children, aged 6-12 years, presenting for an i.v. cannulation were included. The children were allocated to either a 60-min application of anaesthetic cream followed by i.v. cannulation (Group A) or to a 90-min application followed by an interval of 30 min before cannulation (Group B). No sedatives or analgesics were given. The children scored their pain by a faces scale with four faces.


RESULTS
The i.v. cannulations in Group B were less painful than the cannulations in Group A (Mann-Whitney test, P = 0.01). There was no difference between the two groups as regards problems when performing the cannulations.


CONCLUSIONS
i.v. cannulation after application of anaesthetic cream for 90 min followed by a 30-min interval is less painful than the widely used 60-min application directly followed by cannulation.
Gad
L N
LN
Department of Anaesthesia and Intensive Care, Glostrup University Hospital, Copenhagen, Denmark.
Olsen
K S
KS
Lysgaard
A B
AB
Culmsee
M
M
D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002404:Catheterization / Q000009:adverse effects; D002648:Child; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
D000779:Anesthetics, Local; D011318:Prilocaine; D008012:Lidocaine