EMLA cream is an effective local anaesthetic agent for venipunctures in adults and children. The aim of this double-blind, randomised, and placebo-controlled study was to evaluate the effect of EMLA when heel-lancing was performed in neonates. On their third day of life, fullterm healthy infants, who underwent testing for phenylketonuria (PKU) by heel-lancing, were consecutively included in the study. One hundred and twelve neonates were allocated to eight groups according to the application time of EMLA or placebo (10 to 120 minutes). Thus in each group seven infants received active substance and seven placebo. The response to the nociceptive stimulation was assessed by studying the occurrence of a pain cry. No analgesic effect of EMLA was found. There were no adverse effects.

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The Co-Op module improved 'safety climate' and 'teamwork climate' in the operating theatre, which suggests that a deliberate and designed educational intervention can shape a learning environment as a model for the establishment of a safety culture.