title: Use of EMLA cream as a topical anaesthetic before venepuncture procedures in field surveys: A practice that helps children, parents and health professionals.
abstract: BACKGROUND
  Topical analgesia is becoming essential as the number of invasive screening procedures involving children rises steadily. Little is known about the frequency of these procedures, or about interventions to ease the pain.
  
  
  METHODS
  We investigated the use of EMLA cream in 184 school-aged children in KwaZulu-Natal Province, South Africa. Another group of 20 children did not receive any local analgesia and was assessed as a control. Anticipatory anxiety, pain, adverse reactions and ease of procedure were assessed using a subjective visual analogue scale (VAS) pain score generated by the researcher and obtained from each child immediately after the procedure.
  
  
  RESULTS
  The use of EMLA cream resulted in reduced pain and distress. The pain-relieving influence of EMLA was good (91.3% analgesic effect). Participants who received EMLA cream reported significantly lower VAS pain scores (p=0.001). Pain scores generated by the researcher were also significantly lower in the EMLA group than in the control group (p=0.000). No adverse reactions were observed, and the children could continue with other research activities during the application time and after the procedure. Parent or caregiver scores were in favour of EMLA cream.
  
  
  CONCLUSIONS
  EMLA cream was safe and effective for alleviating the pain associated with venepuncture in a fieldwork setting. We therefore believe that it merits a place in the routine premedication of children before phlebotomy and cannulation procedures in clinical settings, research studies and field surveys. Further research is recommended to assess whether EMLA cream can be used for immunisations.
authors.affiliation: Department of Public Health, School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. tgwetu@gmail.com.
authors.forename: T P
authors.initials: TP
authors.lastname: Gwetu
authors.forename: M K
authors.initials: MK
authors.lastname: Chhagan