A blinded, randomized, paired, placebo-controlled trial of 20-minute EMLA cream to reduce the pain of peripheral IV cannulation in the ED |
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Authors: | Loren G Yamamoto MD MPH MBA Rodeny B Boychuk MD |
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Institution: | aFrom Emergency Services, Kapiolani Medical Center For Women And Children, Honolulu, HI. USA;bDepartment of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI. USA |
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Abstract: | A eutectic mixture of local anesthetics (EMLA) in cream from has been used as a topical anesthetic to reduce the pain of procedures penetrating the skin. It is generally applied for 45 to 60 minutes before the painful procedure. The purpose of this study was to determine whether a 20-minute application of EMLA is useful in reducing the pain of routine peripheral intravenous cannulation in the emergency department (ED). A blinded, randomized, placebo-controlled, paired trial compared the pain of intravenous cannulation in both hands of study subjects: one hand was treated with 20-minute EMLA cream and the other hand was treated with 20-minute placebo cream. Forty subjects identified the more painful hand and scored pain measurements of each hand using a 10-cm visual analog scale. These data failed to demonstrate any significant benefit of EMLA compared with placebo. EMLA is not useful for intravenous cannulation when used for 20-minute application times. There may be more effective and less costly ways of reducing the pain of intravenous cannulation that patients would prefer. |
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Keywords: | EMLA lidocaine prilocaine intravenous cannulation |
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