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Research Article | Volume 14 Issue: 3 (May-Jun, 2024) | Pages 903 - 908
Comparative study of 10% lidocaine spray versus eutectic mixture of 2.5% lidocaine and 2.5% prilocaine (EMLA) to attenuate pain of peripheral venous cannulation in children
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1
Associate Professor, Department of Anaesthesia, Government Medical College, Nizamabad, Telangana.
2
Associate Professor, Department of Anaesthesia, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana.
3
Senior Consultant, Department of Paediatrics, Sai Anurag Hospital. Chandanagar, Hyderabad, Telangana
4
Senior Consultant, Department of Paediatrics, Vishnu's Paramitha Hospital, Chandanagar, Hyderabad, Telangana.
Under a Creative Commons license
Open Access
PMID : 16359053
Received
April 3, 2024
Revised
April 19, 2024
Accepted
May 9, 2024
Published
June 5, 2024
Abstract

Background: Eutectic mixture of local anesthetics (EMLA) cream is often used for local anesthesia during spinal injections. Local anesthetic agents may be administered to relieve the pain during any injections. Anesthetic agents often used are eutectic mixture of local anesthetics (EMLA) cream, ethyl chloride, nonsteroidal anti-inflammatory drugs (NSAIDs), lidocaine, and opioid. EMLA cream is often used to decrease the pain during spinal injections. However, this agent has longer onset of action, up to 30 minutes, before the peak of action. Materials and methods: In this prospective single-blind randomized study, ninety Paediatric patients were assigned into Group A (number(n) =45) with Lignocaine 10% spray applied 10 minutes and Group B (n = 45) EMLA cream applied 1 hour prior to cannulation. Vital signs were recorded before, during, and after the procedure. The primary objective of the study was assessment of severity of pain during IV cannulation using 10 cm visual analogue scale (VAS). Secondary objectives such as ease of cannulation and adverse effects were also noted.Result: Demographic data were comparable between the Group A and Group B. There was no significant difference in anthropometrical status such as weight, height, and body mass index between the two groups. In this study, comparing the ASA (American Society of Anesthesiologists) physical status between Group A and Group B. The majority of participants fall under ASA II classification, indicating mild systemic disease. There are slight variations in the distribution of ASA classifications between the two groups, with Group A having no participants classified as ASA I and Group B having one participant classified as ASA I. Otherwise, both groups are predominantly ASA II, with very few participants falling into the ASA III category. In Group A, among a total of 45 participants, 40 participants were cannulated at the first attempt (88.88%), and 5 participants were cannulated with minor adjustments (11.11%). 
Whereas, in Group B, among a total of 45 participants, 41 participants were cannulated at the first attempt (91.11%) and 4 participants were cannulated with minor adjustments (8.8%). The difference was insignificant (P = 0.81). Conclusion: The eutectic mixture of local anesthetic cream and lidocaine cream attenuated pain associated with peripheral venous cannulation to varying degrees. These results definitely indicate that EMLA cream provides more effective relief of the pain resulting from venous cannulation. A more detailed study is necessary to confirm the safety of EMLA cream in various patient groups and under different clinical conditions 

Keywords
INTRODUCTION

Pain during any medical procedures, including spinal anesthesia, should be managed carefully as this would affect the perception and comfort of the patients [1,2].

Local anesthetic agents may be administered to relieve the pain during any injections. Anesthetic agents often used are eutectic mixture of local anesthetics (EMLA) cream, ethyl chloride, nonsteroidal anti-inflammatory drugs (NSAIDs), lidocaine, and opioid [3]. EMLA cream is often used to decrease the pain during spinal injections. However, this agent has longer onset of action, up to 30 minutes, before the peak of action [4].

Venous cannulation is a mandatory procedure for hydration and drug intravenous administration during the perioperative period. However, this procedure must be accompanied by pain. Various methods have been devised to attenuate this pain, one of which is the application of a eutectic mixture of local anesthetics (EMLA) cream. [5] Although few decades have passed since the start of clinical usage of EMLA cream and several clinical studies evaluating its efficacy have been published, in all of these studies, the participants were divided into two groups and each group received only one of the study interventions. [6] However, since there are large individual differences in pain sensitivity, even with the same stimuli, this kind of clinical study design lacks accuracy in pain evaluation. [7] The aim of this study was to precisely elucidate the efficacy of EMLA cream for venipuncture pain relief compared with lidocaine tape, a traditional analgesic method, in the same patients.

MATERIAL AND METHODS:
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