THE EMLA PATCH - A NEW-TYPE OF LOCAL-ANESTHETIC APPLICATION FOR DERMAL ANALGESIA IN CHILDREN

The skin application of EMLA cream under a Tegaderm dressing was compared in children with a new combined dressing/local anaesthetic patch—the EMLA patch. The analgesic effect during venepuncture was assessed using a visual analogue scale (patients) and a verbal rating scale (investigator). Skin adhesiveness and incidence of local skin reactions with the two types of application were also studied. The study was designed as an open randomised trial with two parallel groups. Sixty children, aged between 5 and 15 years were evaluated. After a minimum application time of 60 min an intravenous cannula was inserted. There was no difference in analgesia as assessed by the patients or the investigators. Mild discomfort at removal of the occlusive dressing/patch was observed in a few patients, but there was no difference in the adhesiveness of the Tegaderm dressing and the EMLA patch. Only mild local skin reactions (with paleness in the anaesthetised skin area) were observed in both groups. It was concluded that both the EMLA patch and the Tegaderm/EMLA cream dressing provide effective dermal analgesia for venepuncture with a 0.8 mm (outer diameter) cannula. The two types of application were indistinguishable but the ease of application of the patch is a distinct advantage. 1994 The Association of Anaesthetists of Great Britain and Ireland