Topical analgesia treats pain and decreases propofol use during lumbar punctures in a randomized pediatric leukemia trial

Whitlow, Puja G.; Saboda, Kathylynn; Roe, Denise J.; Bazzell, Susan; Wilson, Cera

doi:10.1002/pbc.25236

Cited by 19 publications

(21 citation statements)

References 26 publications

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“…The outcome of this study revealed that the application effectively anesthetized the teeth and gingiva, so the dental work was performed with comfort. A study 19 demonstrated that the combination of EMLA cream with propofol is beneficial and providing safe and effective pain management for lumbar punctures.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of benzocaine in reducing deep cavity restoration and post-extraction stress in dental patients

Al-Samadani

Gazal

2015

SMJ

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Objectives:To investigate the effectiveness of topical anesthetic, 20% benzocaine in relieving pain and stress in patients following deep cavity restoration and extraction of teeth under local anesthesia (LA).Methods:A prospective clinical trial was conducted from October 2014 until April 2015 at Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. Forty-five patients were included in the 20% benzocaine group, and 46 in the normal saline group. Evaluation of the dental stress was made pre-operatively and immediately post-operative treatment using the visual analogue scale (VAS). Furthermore, discomfort of the injections were recorded by the patients after each treatment on standard 100 mm VAS, tagged at the endpoints with “no pain” (0 mm) and “unbearable pain” (100 mm).Results:There were statistically significant differences between the mean stress scores for patients in the benzocaine and normal saline groups post-operatively (p=0.002). There were significant differences between the mean pain scores for patients in the post buccal injection (p=0.001), post palatal injection (p=0.01), and the post inferior alveolar nerve block groups (p=0.02). Buccal, palatal, and inferior alveolar nerve block injections were more painful for patients in the normal saline group than the benzocaine group.Conclusion:This investigation has demonstrated that post-operative stress associated with deep cavity restoration and dental extractions under LA can be reduced by the application of topical anesthetic (20% benzocaine) at the operative site for intra-oral injections.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of benzocaine in reducing deep cavity restoration and post-extraction stress in dental patients

Al-Samadani

Gazal

2015

SMJ

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“…Sedation for the children in this study was performed by intravenous administration of Propofol in available central iv access. EMLA (eutectic mixture of local anesthetics) was used as a pain reliever (Whitlow et al, 2015). The sedation was administrated in the presence of the child's parent, who left the room when the child was no longer awake.…”

Section: The Procedures -Sedation For Intrathecal Chemotherapymentioning

confidence: 99%

“…Numerous psychological interventions, such as cognitive-behavioural strategies, hypnosis, virtual reality and music therapy, have thus been introduced to reduce children's stress and anxiety (Flowers and Birnie, 2015;Nguyen et al, 2010;Nilsson et al, 2009;Richardsson et al, 2006). Most interventions to promote children's well-being during treatment with intrathecal chemotherapy requiring lumbar puncture are pharmacological (Whitlow et al, 2015). The procedure for receiving sedation for intrathecal chemotherapy does, however, create a particularly difficult situation for the child.…”

Section: Introductionmentioning

confidence: 99%

Creating a shielding place for children with leukaemia during sedation for intrathecal chemotherapy: A grounded theory study

Sjöberg

Carlsson

Källstrand

et al. 2020

European Journal of Oncology Nursing

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“…The absence of any sign of local erythema, swelling, and allergic reaction was verified, and the skin was wiped dry and sterilized according to standard procedures prior to performing the LP. Additional intermittent bolus doses of 0.5 to 1 mg/kg of propofol were administered when needed to avoid movement of the patient related to the procedure . The patients had continuous monitoring of their electrocardiogram, respiratory rate, capnography, pulse oximetry, and noninvasive measurement of blood pressure every 3 minutes.…”

Section: Methodsmentioning

confidence: 99%

“…Propofol is a general anesthetic drug that is administered as a single drug or in combination with systemic or local analgesics for procedural sedation . Fentanyl and alfentanil are the commonly used systemic analgesics, and subcutaneous 1% lidocaine injection or eutectic mixture of lidocaine and prilocaine cream (EMLA cream) application are the commonly used local analgesics for these procedures . Inclusion of systemic or local analgesic to propofol has been demonstrated to improve pain control with fewer adverse effects .…”

Section: Introductionmentioning

confidence: 99%

Eutectic mixture of lidocaine and prilocaine versus 1% lidocaine injection for lumbar punctures in pediatric oncology patients

Cruickshank

Qeadan

Kuttesch

et al. 2019

Pediatric Blood & Cancer

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Background:The role of local analgesics for lumbar punctures (LPs) in pediatric oncology patients has not been specifically studied.Aim: To compare the efficacy of eutectic mixture of local anesthetics (EMLA) cream to 1% lidocaine injection for LPs. Method:This was a retrospective observational study of all patients receiving either EMLA cream (EMLA group) or 1% lidocaine subcutaneous injection (lidocaine group) in addition to fentanyl and propofol for LPs over 18 months. Demographics, vital parameters, procedural and recovery times, propofol and fentanyl doses, and adverse events were studied. Results: Two hundred ninety LPs in 49 children were studied: 148 in the EMLA group and 142 in the lidocaine group. There was no difference in demographics or preprocedural parameters between the two groups. LPs in the EMLA group were completed in a shorter time (7.5 minutes [CI 7.0-8.1] vs 9.4 minutes [CI 8.9-9.9]) with a faster recovery time (38.7 minutes [CI 36.9-40.9] vs 43.9 minutes. [CI 41.9-45.9]) as compared with the lidocaine group (P < 0.001). The EMLA group required less maintenance doses (0.54 mg/kg [CI 0.47-0.62] vs 1.14 mg/kg [CI 1.06-1.21]) and total doses (2.58 mg/kg [CI 2.42-2.75] vs 3.12 mg/kg [CI 2.95-3.29]) of propofol as compared with the lidocaine group (P < 0.0001). Adverse events in the EMLA group were less (19% vs 41%) as compared with the lidocaine group (P < 0.0001). Conclusion:The addition of EMLA cream for procedural sedation for LPs in pediatric oncology patients significantly improves pain management in comparison with 1% lidocaine injection. K E Y W O R D SEMLA cream, local anesthetic, lumbar puncture, pediatric oncology, procedural sedation

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Topical analgesia treats pain and decreases propofol use during lumbar punctures in a randomized pediatric leukemia trial

Abstract: This study demonstrated that the combination of EMLA cream with propofol is beneficial. Topical analgesics are at the discretion of the oncologist, allowing us to advocate for patients by providing safe and efficacious pain management for lumbar punctures.

Cited by 19 publications

References 26 publications

Effectiveness of benzocaine in reducing deep cavity restoration and post-extraction stress in dental patients

Effectiveness of benzocaine in reducing deep cavity restoration and post-extraction stress in dental patients

Creating a shielding place for children with leukaemia during sedation for intrathecal chemotherapy: A grounded theory study

Eutectic mixture of lidocaine and prilocaine versus 1% lidocaine injection for lumbar punctures in pediatric oncology patients

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