Abstract
Background: Venous cannulation is a painful procedure that is associated with anxiety, distress and discomfort. But pain is frequently overlooked in adults.Aims and Objective: We compared the efficacy of 5% EMLA cream and 10% lidocaine cream in attenuating pain associated with peripheral venous cannulation.Methods: This prospective, randomized, placebo-controlled trial was conducted in 102 ASA I and II adults scheduled for elective surgery. They were randomly allocated by blind balloting to one of three groups: group E had 1.5 mL of EMLA cream, group L 1.5 mL of 10% lidocaine cream, and group P 1.5 mL KY gel. All cream was applied over a visible vein for 60 min with occlusive dressing. Pain was evaluated using visual analogue scale (VAS) and verbal rating scale (VRS).Results: The mean VAS score was significantly lower with either EMLA cream (2.62±1.76 cm) or 10% lidocaine cream (1.85±1.58 cm) than with placebo (4.78 ±1.88 cm), p<0.001. Most patients who received EMLA cream (76.5%) or 10% lidocaine cream (70.6%) compared with placebo (55.9%) had mild pain during cannulation using VRS.Conclusion: The eutectic mixture of local anesthetic cream and lidocaine cream attenuated pain associated with peripheral venous cannulation to varying degrees.Keywords: Venous cannulation pain, 10% lidocaine, EMLA, VAS, VRS, Side effects
Highlights
Crile Washington invented the cannula and used intravenous therapy for the management of shock; this management popularized venous cannulation (1)
We have demonstrated that visual analogue scale (VAS) was lower after application of EMLA and 10% lidocaine cream 60 min before venous cannulation than after application of KY gel; the placebo cream (KY gel)
VAS was comparable with EMLA and 10% lidocaine cream
Summary
Crile Washington invented the cannula and used intravenous therapy for the management of shock; this management popularized venous cannulation (1). Peripheral venous cannulation is a routine procedure during the delivery of anesthesia, which many adults find painful. Inadequate pain relief is unpleasant for patients but may cause anxiety about further treatment, deter patients from seeking medical care in the future (2), and result in increase in heart rate and blood pressure (3). The increase in heart rate and blood pressure leads to increased myocardial oxygen consumption and increased risk of myocardial infarction in patients at risk, especially those with hypertension and coronary artery disease (4). The use of topical anesthetic agents for venous cannulation is on the increase (5). We compared the efficacy of topical 5% EMLA cream and 10% lidocaine cream in attenuating pain associated with peripheral venous cannulation in adults
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