Comparison of percutaneous anaesthesia for venous cannulation after topical application of either amethocaine or EMLA cream

Molodecka, J.; Stenhouse, Claire; Jones, Justin M.; Tomlinson, A. A.

doi:10.1093/bja/72.2.174

Cited by 47 publications

(41 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 However one study using a 5% preparation reported no significant erythema. 24 One hour was chosen as the application time for both EMLA and Ametop TM. This complied with manufacturers recommendations i.e.…”

Section: Discussionmentioning

confidence: 99%

Topical amethocaine (Ametop™) is superior to EMLA for intravenous cannulation

Browne

Awad

Plant

et al. 1999

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: A eutectic mixture of local anesthetics (EMLA) is commonly used to provide topical anesthesia for intravenous (iv) cannulation. One of its side effects is vasoconstriction, which may render cannulation more difficult. A gel formulation of amethocaine (Ametop") is now commercially available. The aim of this study was to compare EMLA and Ametop TM with regard to the degree of topical anesthesia afforded, the incidence of vasoconstriction and the ease of iv cannulation. Methods: Thirty two ASAI adult volunteers had a # 16 gauge iv cannula inserted on two separate occasions using EMLA and Ametop TM applied in a double blind fashion for topical anesthesia. Parameters that were recorded after each cannulation included visual analogue pain scores (VAPS), the presence of vasoconstriction and the ease of cannulation, graded as: I = easy, 2 = moderately difficult, 3 = difficult and 4 = failed. Results: The mean VAPS + SD after cannulation with Ametop'~ M was 12 + 9.9 and with EMLA was 25.3 -+ 16.6 (P = 0.002). Vasoconstriction occurred after EMLA application on 17 occasions and twice after Ametop TM (P = 0.001). The grade of difficulty of cannulation was 1.44 _+ 0.88 following EMLA and 1.06 _+ 0.25 with Ametop TM (P = 0.023). Conclusions: Intravenous cannulation was less painful following application of Ametof" than EMLA. In addition, Ametop TM caused less vasoconstriction and facilitated easier cannulation. Its use as a topical anesthetic agent is recommended, especially when iv access may be problematic.Objectif : Un m~lange eutectique d'anesth&iques Iocaux (MEAL) est souvent utilis6 pour I'anesth6sie topique Iors d'une canulation intraveineuse (iv). La vasoconstriction, qui est I'un des effets secondaires du MEAL, peut compliquer la mise en place d'une canule. Une pr&entation en gel d'am&hocaine (Ametop TM) est maintenant offerte dans le commerce. Le but de la pr&ente 6tude &ait de comparer le MEAL et I'Ametop TM en regard du degrE d'anesth&ie topique foumi, de rincidence de la vasoconstriction et de la facilitE de la canulation iv. M&hode : On a ins&E, en deux occasions s6par&s chez 32 volontaires adultes d'&at physique ASA I, une canule iv de calibre 16 en utilisant en double aveugle le MEAL et Ametop TM pour rEaliser ranesth6sie topique. Apr& chaque canulation, on a enregistr6 les param&res suivants : les scores de douleur ~ I'&helle visuelle analogue (EVA), la presence de vasoconstriction et la facilit6 de canulation notEe I = facile, 2 = mod&Ement difficile, 3 --di~cile et 4 = impossible. l~uJ.tats : Les scores moyens ~ I'E--VA + I'&art type ont ~t~ de 12 -9,9 ~ la suite de la canulation avec Ametop TM Met de 25,3 _+ 16,6 apr& le MEAL (P = 0,002). La vasoconstriction est survenue en 17 occasions apr& I'application du MEAL et deux fois plus souvent apr& Ametop TM (P --0,00 I). Le degr6 de difficult6 de canulation a 6t6 de 1,44 _+ 0,88 apr& le MEAL et de 1,06 +_ 0,25 apr& Ametop TM (P = 0,023). Conclusion : La canulation intraveineuse est moins douloureuse apr& I'application d'Ametop TM que celle du MEAL. D...

show abstract

Section: Discussionmentioning

confidence: 99%

Topical amethocaine (Ametop™) is superior to EMLA for intravenous cannulation

Browne

Awad

Plant

et al. 1999

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…If the study presented results in bar graph format, 21-23 2 reviewers independently extracted numeric data through measurement of the graphs with a ruler, and these results were averaged. In 2 papers, 22,23 SDs were calculated from individual pain scores. In 1 article, 23 the SD was calculated from the 95% confidence interval (CI).…”

Section: Methodsmentioning

confidence: 99%

Topical Anesthetics for Dermal Instrumentation: A Systematic Review of Randomized, Controlled Trials

Eidelman

Weiss

Lau

et al. 2005

Annals of Emergency Medicine

View full text Add to dashboard Cite

“…Topical anaesthetic agents have been shown to relieve distress in children [2][3][4] and adults [5] during venepuncture and venous cannulation, as well as proving effective in capillary heel prick blood sampling in neonates [6] .…”

Section: Introductionmentioning

confidence: 99%

Rapid Human Skin Permeation and Topical Anaesthetic Activity of a New Amethocaine Microemulsion

Escribano

Obach²,

Arévalo³

et al. 2005

Skin Pharmacol Physiol

View full text Add to dashboard Cite

We developed a fast-acting, topical, 4% (w/w) amethocaine microemulsion and tested its in vitro permeation in isolated human skin. Comparison with a commercial amethocaine gel (Ametop^® ) was performed using Franz diffusion cells. Permeability coefficient (k_p), flux (J) and percentage permeation after 10 h of microemulsion application were, in all cases, 1.5 times higher than those of the gel. The values obtained for the P₁ parameter [1], 1.06·10^–2 cm (microemulsion) and 0.724·10^–2 cm (gel) indicate that the microemulsion excipients favour amethocaine deposition in the skin, increasing the permeability coefficient, amount of drug retained in the skin, and the flux achieved. Analgesic activity was also examined in rats made hyperalgesic or allodynic after carrageenan-induced inflammation. The rats were distributed into four groups (n = 5–9 per group), each group receiving topically either amethocaine microemulsion, amethocaine gel (Ametop), amethocaine subcutaneous infiltration or nothing (controls). In edematous paws, anti-hyperalgesic activity appeared at 4.2 and 13.8 min after application of amethocaine microemulsion and gel, respectively. These effects are lower than after 0.5% w/w amethocaine infiltration. Amethocaine microemulsion was the only topical formulation with an anti-allodynic effect, although this effect was less than with amethocaine infiltration. These results suggest that microemulsion could be a valuable formula for improving amethocaine permeation and thus bringing rapid pain relief.

show abstract

Comparison of percutaneous anaesthesia for venous cannulation after topical application of either amethocaine or EMLA cream

Cited by 47 publications

References 0 publications

Topical amethocaine (Ametop™) is superior to EMLA for intravenous cannulation

Topical amethocaine (Ametop™) is superior to EMLA for intravenous cannulation

Topical Anesthetics for Dermal Instrumentation: A Systematic Review of Randomized, Controlled Trials

Rapid Human Skin Permeation and Topical Anaesthetic Activity of a New Amethocaine Microemulsion

Contact Info

Product

Resources

About