The clinical efficacy of EMLA cream for intravenous catheter placement in client-owned dogs

Oostrom, Hugo van; Knowles, Toby G

doi:10.1016/j.vaa.2018.03.009

Cited by 24 publications

(16 citation statements)

References 11 publications

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“…This finding is consistent with the results obtained by previous studies conducted in children and cats where the efficacy of the anaesthetic cream was evaluated after an application time shorter than 60 mins (ie, the application time recommended by the manufacturer). 3,8 However, a controlled study evaluating the efficacy of the EMLA cream in dogs after application times of 30 and 60 mins showed a significantly reduced reaction to intravenous catheter placement only after 60 mins of action 11. Differences inherent to the skin and behaviour of the species, as well as peripheral vasoconstriction induced by stress, 16,19 could all be factors that contribute to the effectiveness of the shorter application time able to provide an analgesic effect.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of eutectic lidocaine/prilocaine cream for jugular blood sampling in cats

Crisi

Santis

Giordano

et al. 2020

Journal of Feline Medicine and Surgery

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Objectives The study aimed to evaluate the efficacy of a eutectic lidocaine/prilocaine cream (EMLA cream; Astra Pharmaceuticals) in reducing pain and reaction to venepuncture during jugular blood sampling in cats after a 30-min topical application time. Methods The study was a prospective, blind, controlled clinical trial. Eighteen healthy client-owned cats were randomly allocated to two study groups. All cats were clipped on the left jugular groove region and then, depending on the study group, either the placebo (liquid paraffin) or EMLA cream was applied to the region. The area was then kept protected for the next 30 mins. Except for the operator who administered the product, all operators were blinded to the study groups. Blood sampling was performed by an experienced operator and a stress score was assigned to each cat according to the reactions observed during the venepuncture. Also, the procedure was classified as being ‘easy’ or ‘difficult’ by the same operator. Results A significantly reduced stress score was observed in cats that received the EMLA cream compared with those belonging to the placebo group ( P = 0.048); withdrawal movements were observed in 1/9 cats treated with the EMLA cream vs 7/9 cats of the placebo group ( P = 0.015). The jugular venepuncture was defined as easy in 1/9 cats that received the placebo and in 8/9 cats in the EMLA group ( P = 0.015). Conclusions and relevance The present study provides evidence for the efficacy of the EMLA cream after a 30-min application time for jugular venepuncture in cats, together with significantly reduced stress for patients. Therefore, this study supports the routine use of EMLA cream as good practice to enhance the welfare of cats and to simplify venepuncture procedures.

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Section: Discussionmentioning

confidence: 99%

“…9,10 Similar studies have also been conducted for dogs. 7,11 Despite the evidence of promising results in both species, the manufacturer-recommended application time to obtain an appropriate analgesic effect is 60 mins. This could present itself as a limitation to the daily use of EMLA cream in the veterinary practice.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of eutectic lidocaine/prilocaine cream for jugular blood sampling in cats

Crisi

Santis

Giordano

et al. 2020

Journal of Feline Medicine and Surgery

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“…The application of EMLA cream (active ingredients lidocaine/prilocaine) can reduce defensive movements in dogs during catheterisation; however, an application time of 60 minutes is necessary (no observable difference to placebo after 30 minutes) [70]. In already sedated cats, a positive effect of EMLA on struggling during jugular catheterisation has been reported just 20 minutes after application [71].…”

Section: Reducing the Perception Of Painmentioning

confidence: 99%

A Review on Mitigating Fear and Aggression in Dogs and Cats in a Veterinary Setting

Riemer¹,

Heritier²,

Windschnurer³

et al. 2020

Preprint

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A high proportion of dogs and cats are fearful during veterinary visits, which in some cases may escalate into aggression. Here, we discuss factors that contribute to negative emotions in a veterinary setting and how these can be addressed. The set-up of the waiting area (e.g. spatial dividers; elevated places for cat carriers), tailoring the examination and the treatment to the individual, considerate handling (minimal restraint when possible, avoiding leaning over or cornering animals) and offering high-value food or toys throughout the visit can promote security and, ideally, positive associations. Desensitisation and counterconditioning are highly recommended both to prevent and address existing negative emotions. Some negative experiences such as short-term pain from injections can be minimised by using tactile and cognitive distractions. Preemptive analgesia is recommended for known painful procedures. Recommendations for handling fearful animals to minimise aggressive responses are discussed. However, anxiolytics or sedation should be used whenever there is a risk of traumatising an animal or for safety reasons. Stress-reducing measures can decrease stress and fear in patients and consequently their owners – thus strengthening the relationship with the clients as well as increasing the professional satisfaction of veterinary staff.

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“…In children, topical lidocaine [2] or combination lidocaine-prilocaine preparations [3][4][5] applied before injection has been shown to reduce pain responses for intramuscular vaccination [2,3,5] as well as for caudal epidural anesthesia infusion [4]. Similarly, in dogs, topical lidocaine-prilocaine applied 60 min before intravenous catheter placement reduced behavioral reactions [6]. Cats that were treated with topical lidocaine-prilocaine 60 min in advance of catheter placement tended to struggle less compared to controls, such that catheters were successfully placed without sedation in 60% of the treated cats compared to 38% of controls [7].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Lidocaine Topical Solution in Reducing Discomfort Reaction of Horses to Intramuscular Vaccination

Torcivia

McDonnell

2022

Animals

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Vaccinations via intramuscular injection are a key component of preventative health care in horses. Development of problematic behavioral aversion to injections is quite common. Our clinical impression has been that topical anesthetic applied to injection sites can reduce the behavioral reaction; however, this has not been critically tested. To blindly evaluate efficacy, either 5% or 10% topical lidocaine solution or 0% control was applied to injection sites for 78 ponies two minutes before intramuscular vaccination. Mean reaction scores on a scale of 0–3 were 0.84 (se 0.18) for 5% lidocaine solution, 0.62 (se 0.14) for 10% lidocaine solution, compared to 1.30 (se 0.19) for 0% control solution. Reaction scores for both the 5% and 10% lidocaine were significantly lower than for the control group. Additionally, the proportion of subjects with a reaction greater than a slight flinch was 2 of 25 for the 5% lidocaine, 5 of 26 for the 10% lidocaine and 15 of 27 for the 0% lidocaine control. For both the 5% and 10% lidocaine groups, the proportion differed significantly from the control. The difference between the 5% and 10% lidocaine groups was not statistically significant. These findings confirm our clinical impression that application of topical anesthetic just two minutes in advance of intramuscular injection can effectively reduce the behavior reaction of horses.

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The clinical efficacy of EMLA cream for intravenous catheter placement in client-owned dogs

Abstract: This study shows that EMLA cream applied for 60 minutes reduces the behavioural reaction of dogs to IV catheter placement; therefore, this intervention can be advocated for routine use in veterinary medicine to enhance the welfare of dogs undergoing IV catheter placement.

Cited by 24 publications

References 11 publications

Evaluation of eutectic lidocaine/prilocaine cream for jugular blood sampling in cats

Evaluation of eutectic lidocaine/prilocaine cream for jugular blood sampling in cats

A Review on Mitigating Fear and Aggression in Dogs and Cats in a Veterinary Setting

Efficacy of Lidocaine Topical Solution in Reducing Discomfort Reaction of Horses to Intramuscular Vaccination

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