Does topical Amethocaine cream increase first-time successful cannulation in children compared with a eutectic mixture of local anaesthetics (EMLA) cream? A systematic review and meta-analysis of randomised controlled trials

Pywell, Alison; Xyrichis, Andreas

doi:10.1136/emermed-2014-204066

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…38 A systematic review of six paediatric trials that compared amethocaine to EMLA concluded that amethocaine was superior in reducing the pain of intravenous cannulation. 39 Although amethocaine is thought to have vasodilatory effects, the available literature reported that the success rates for cannulation were similar to those that used The patch significantly reduced the pain of intravenous cannulation compared to EMLA, each applied for 35 minutes. 41 A multicentre study compared 339 children who were prepared with Rapydan for 30 minutes or EMLA for 60 minutes before venepuncture or intravenous catheterisation.…”

Section: Topical Anaesthetic Creamsmentioning

confidence: 91%

“…One study compared Ametop Gel 4% (Smith and Nephew), which contains 4% amethocaine, to 4% liposomal cream and found that 30 minutes after they were applied, they both resulted in similar self‐reported pain scores during intravenous cannulation 38 . A systematic review of six paediatric trials that compared amethocaine to EMLA concluded that amethocaine was superior in reducing the pain of intravenous cannulation 39 . Although amethocaine is thought to have vasodilatory effects, the available literature reported that the success rates for cannulation were similar to those that used EMLA 39 …”

Section: Pharmacological Interventionsmentioning

confidence: 99%

“…A systematic review of six paediatric trials that compared amethocaine to EMLA concluded that amethocaine was superior in reducing the pain of intravenous cannulation 39 . Although amethocaine is thought to have vasodilatory effects, the available literature reported that the success rates for cannulation were similar to those that used EMLA 39 …”

Section: Pharmacological Interventionsmentioning

confidence: 99%

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A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation

2020

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Venepuncture and peripheral intravenous cannulation are two of the most commonly paediatric performed medical procedures in many healthcare settings. These procedures can cause significant pain and distress at any age, during childhood, so appropriate management is strongly recommended. This review examines the evidence related to pain and distress management during venepuncture and peripheral intravenous cannulation, including preparing the environment, assessing and preparing patients, parental involvement and psychological and pharmacological interventions. It specifically refers to neonates, children with cognitive impairment and children with difficult intravenous access. We provide a brief management strategy, with easily implemented techniques to improve daily practice.

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Section: Topical Anaesthetic Creamsmentioning

confidence: 91%

Section: Pharmacological Interventionsmentioning

confidence: 99%

Section: Pharmacological Interventionsmentioning

confidence: 99%

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A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation

2020

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“…There are many dosage forms available, such as patches, sprays, gels, lotions, creams, or ointments, ensuring various options, to be chosen by the clinician according to the case. Some of them also provide increased absorption of the anesthetic, such as the transdermal patch [35,36].…”

Section: An Update On Topical Anestheticsmentioning

confidence: 99%

Nanotechnology approaches for pain therapy through transdermal drug delivery

Peptu¹,

Rotaru²,

Ignat³

et al. 2015

CPD

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The paper focuses on the advances in the field of pain treatment by transdermal delivery of specific drugs. Starting from a short description of the skin barrier, the pharmacodynamics and pharmacokinetics including absorption, distribution, action mechanism, metabolism and toxicity, aspects related to the use of pain therapy drugs are further discussed. Most recent results on topical anesthetic agents as well as the methods proved to overcome the skin barrier and to provide efficient delivery of the drug are also discussed. The present review is proposing to summarize the recent literature on the pharmacotherapeutic principles of local anesthetics and non-steroidal anti-inflammatory drugs, generally used to alleviate pain but also the drugs as nanoformulations with potential applications in transdermal delivery. A special attention is given to efficient formulations meant for transdermal penetration enhancement of anesthetics where the drug is encapsulated into macrocyclic molecules (cyclodextrins, cyclodextrin derivatives), liposomes or polymer nanoparticles and hydrogels.

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“…When it came to the influence of different local anaesthetics on the needle procedure success rate, specific comparisons were only available for tetracaine gel and EMLA cream and these showed that tetracaine gel did not significantly increase the successful first-time cannulation rate compared to EMLA cream (21,22).…”

Section: Accepted Articlementioning

confidence: 99%

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

et al. 2017

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Accepted ArticleThis article is protected by copyright. All rights reserved. Aim: More than 50% of children report apian during venipuncture or intravenous cannulation and using local anaesthetics before needle procedures can lead to different success rates. This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream. Methods:We conducted this multicentre randomised controlled trial at three tertiary-level children's hospitals in Italy in 2015. Children aged 3-10 years were enrolled in an emergency department, paediatric day hospital and paediatric ward and randomly allocated to receive a warm lidocaine and tetracaine patch or EMLA cream. The primary outcome was the success rate at the first attempt. Results:The analysis included 172 children who received a warm lidocaine and tetracaine patch and 167 who received an EMLA cream. The needle procedure was successful at the first attempt in 158 children (92.4%) who received the warm patch and in 142 children (85.0%) who received the cream (p=0.03). The pain scores were similar in both groups. Conclusion:This study showed that the first-time needle procedure success was 7.4% higher in children receiving a warm lidocaine and tetracaine patch than EMLA cream. Accepted ArticleThis article is protected by copyright. All rights reserved.Keywords: eutectic mixture of lidocaine and tetracaine cream; local anaesthetic; needle procedure; procedural success rate; warm lidocaine and tetracaine patch Key notes:• Applying local anesthetics may influence success rates in children undergoing painful needle procedures.• We compared how many needles were inserted at the first attempt when children received a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream.• The three Italian hospitals who took part reported that the success rate was higher in children treated with the warm patch (92.4%) than the cream (85.0%). AbbreviationsARR, absolute risk reduction; CI, confidence intervals; EMLA, eutectic mixture of lidocaine and tetracaine; IQR, interquartile ranges; NNT, number need to treat; RR, relative risks

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Does topical Amethocaine cream increase first-time successful cannulation in children compared with a eutectic mixture of local anaesthetics (EMLA) cream? A systematic review and meta-analysis of randomised controlled trials

Cited by 8 publications

References 17 publications

A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation

A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation

Nanotechnology approaches for pain therapy through transdermal drug delivery

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

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