Author(s):
Jayashree Sen, Parvati S, Bitan Sen
Email(s):
jayashree_sen@rediffmail.com
DOI:
10.5958/0974-360X.2020.00272.3 
Address:
Dr. Jayashree Sen1, Dr. Parvati S2*, Dr. Bitan Sen3
1Professor, Deptt. of Anaesthesia J.N.M.C. and A.V.B.R.H. Wardha.
2M.D. Junior Resident, Deptt. of Anaesthesia J.N.M.C., A.V.B.R.H. Wardha.
3DNBSS Senior Resident, Deptt. of Critical Care Medicine Bombay Hospital Institute of Medical Science, Mumbai.
*Corresponding Author
Published In:
Volume - 13,
Issue - 3,
Year - 2020
ABSTRACT:
Background: Venous cannulation,the most commonly performed invasive procedure in hospital patients, causes pain and discomfort and is associated with high incidences of vasovagal reactions and pressor responses. Objectives: The study aims at evaluation of the efficacy of EMLA (eutectic mixture of local anaesthetic) cream to produce dermal analgesia for venous cannulation. Material and Methods: 60 patients were selected randomly of either gender and divided into two groups of 30 patients each. In group-E EMLA cream was applied and in group-P placebo cream was applied at the site of intravenous cannulation one hour prior . Pain following intravenous cannulation was assessed by Visual Analogue Scale (VAS). Results: The mean VAS score among the patients who were applied with EMLA cream was less( 0.467±0.5074), when compared with the mean VAS pain score in the patients who were applied with placebo ointment (4.467±0.5074) No side effect was reported. Conclusion: Application of EMLA cream is effective to produce dermal analgesia in response to venous cannulation.
Cite this article:
Jayashree Sen, Parvati S, Bitan Sen. Evaluation of Dermal analgesia for Venous Cannulation on application of Topical EMLA cream. Research J. Pharm. and Tech 2020; 13(3):1495-1498. doi: 10.5958/0974-360X.2020.00272.3
Cite(Electronic):
Jayashree Sen, Parvati S, Bitan Sen. Evaluation of Dermal analgesia for Venous Cannulation on application of Topical EMLA cream. Research J. Pharm. and Tech 2020; 13(3):1495-1498. doi: 10.5958/0974-360X.2020.00272.3 Available on: https://rjptonline.org/AbstractView.aspx?PID=2020-13-3-77
REFERENCE
1. Speirs AF, Taylor KH, Joanes DN, Girdler NM. A randomised, double-blinded, placebo-controlled, comparative study of topical skin analgesics and the anxiety and discomfort associated with venous cannulation. Br Dent J 2001;190:444-54.
2. Ravel T, Weinberg A, Sibirsky O, Caspi R et al. Efficacy of the topical anesthetic cream, EMLA in alleviating both needle insertion and injection pain. Annals of Plastic Surgery. Dec. 1995; 35 (6): 576-579.
3. Jackson T, McLure HA. Pharmacology of local anesthetics. Ophthalmol Clin North Am 2006;19:155-61.
4. Smith AJ, Stacey MR. Topical ibuprofen for skin analgesia prior to venepuncture. Anaesthesia 1996;51(5):495-7.
5. Armstrong P, Young C, McKeown D. Ethyl chloride and venepuncture pain; a comparison with intradermal lidocaine. Canadian Journal of Anaesthesia 1990;37(6):656-8.
6. Moppett IK, Szypula K, Yeoman PM. Comparison of EMLA and lidocaineionotrophoresis for cannulation analgesia. Eur J Anaesthesiol 2004;21(3)210-3 .
7. Maddi R, Horrow JC, Mark JB, et al. Evaluation of a new cutaneous topical anaesthesia preparation. Regional Anaesthesia 1990;15(3):109-12 .
8. Mriyunjay K,Chawla R,Goyal M,Topical Anaesthesia.Journal of Anaesthesiology and Clinical pharmacology.Year:2015| Volume: 31| Issue :4| Page:450-456 .
9. Hallen B, Olsson G, Uppfeldt A. Pain free venepuncture – Effect of timing of application of local anesthetic cream. Anesthesia. 1984; 39: 969-972.
10. Richard C Chapman, Karen LS. Measurement of pain. Chapter-15 In: John D Loeser editor, Bonicas Management of Pain 3rd edition, New York, Lippincott Williams and Wilkins. 2001; page 311-312.
11. Smith AJ, Stacey MR. Topical ibuprofen for skin analgesia prior to venepuncture. Anesthesia. 1996; 51: 495-497.
12. Vaghadia H, Al-Ahlan OA, Nevin K. EMLA patch for intravenous cannulation in adult surgical outpatiens. Canadian Journal of Anesthesia. 1997; 44(8): 798-802.
13. Speirs AF, Taylor KH, Joanes DN, et al. A randomized double blind, placebo-controlled, comparative study of topical skin analgesia and the anxiety and discomfort associated with venous cannulation. Br Dent J 2001;190(8):444-9
14. Cordoni A, Cordoni LE. Eutectic mixture of local anesthetics reduces pain during intravenous catheter insertion in the pediatric patient. Clin J Pain. 2001 June; 17(2): 115-8.
15. Matsumoto T, Chaki T.The eutectic mixture local anesthetics (EMLA) cream is more effective on venipuncture pain compared with lidocaine tape in the same patients.JA Clinical Reports (2018) 4:73 Page 2 - 6.
16. Oni G, Brown S, Kenkel J. Comparison of five commonly-available, lidocaine-containing topical anesthetics and their effect on serum levels of lidocaine and its metabolite monoethylglycinexylidide (MEGX). Aesthet Surg J. 2012; 32: 495–503.
17. Sawyer J, Febbraro S, Masud S, Ashburn MA, Campbell JC. Heated lidocaine/tetracaine patch (Synera, Rapydan) compared with lidocaine/prilocaine cream (EMLA) for topical anaesthesia before vascular access. Br J Anaesth. 2009;102:210–5 .
18. Fields JM, Piela NE, Au AK, Ku BS. Risk factors associated with difficult venous access in adult ED patients. Am J Emerg Med. 2014;32:1179–82.
19. Piredda M, Biagioli V, Barrella B, Carpisassi I, Ghinelli R, Giannarelli D, De Marinis MG. Factors affecting difficult peripheral intravenous cannulation in adults: a prospective observational study. J Clin Nurs. 2017;26:1074–84.