THICKLY AND THINLY APPLIED LIGNOCAINE-PRILOCAINE CREAM PRIOR TO VENIPUNCTURE IN CHILDREN

EMLA cream (Astra Pharmaceuticals) which contains lignocaine and prilocaine, is widely used in a thick layer to reduce the pain associated with venepuncture. Application of smaller amounts of cream lowers cost and may reduce side-effects. The efficacy of a thick layer (using 2.0 ml) and a thin layer (using 0.5 ml) of lignocaine-prilocaine cream prior to venepuncture was compared in a randomised study of one hundred children. Pain with venepuncture was assessed using a behavioural rating scale as none, slight, moderate or severe. Children in the thin layer study group experienced slight pain more often than children in the thick layer study group (P < 0.01). No child in either group experienced moderate or severe pain. It is concluded that a thin layer of lignocaine-prilocaine cream is not as effective as a thick layer in producing the pain-free venepuncture which is desirable in children.