A comparison of the impact of time on the analgesic efficacy of emla cream application in children undergoing venipuncture: A randomized controlled trial

Abstract

BackgroundIntravenous catheterization (venipuncture) is a common and relatively painful procedure carried out routinely in healthcare facilities. Topical Eutectic Mixture of Local Anesthetics (EMLA) has been advocated to reduce the pain associated with venipuncture in children. However, it is not precisely understood how long EMLA should be applied prior to the procedure. Some studies recommend the use of EMLA at least 60 min prior to the procedure. This study was performed to evaluate the effectiveness of EMLA when used with a shorter preparation time prior to the procedure. MethodsIn this double-blinded clinical trial, 231 patients aged 2 to 6 years were enrolled and randomly allocated into three groups. Group 1 received EMLA cream 20 min before venipuncture, group 2 received EMLA cream 60 min before venipuncture, and group C received vitamin A ointment as a control group. Pain intensity was recorded in groups based on the FLACC score. Study participants, nurses, and evaluators were blinded to the treatment group. ResultsPain severity was lower in groups 1 (mean score = 1.96) and 2 (mean score = 1.56) compared to the controls (mean score = 8.7; P<0.001). There was no difference in pain severity between groups 1 and 2 (P = 0.134). ConclusionEMLA cream significantly reduces the pain associated with venipuncture in children. Also, the application of topical EMLA 20 min before venipuncture is as practical as using it 60 min before this procedure.