Comparison of lignocaine-prilocaine cream and amethocaine gel for local analgesia before venepuncture in children

The efficacy of lignocaine-prilocaine cream (EMLA(TM)) and amethocaine gel (Ametop(TM)) in reducing the pain and distress of venepuncture was compared in a single-blind randomized study of 34 children aged 1-14y. The influences of age, anxiety and past experience were also investigated. Pain was assessed by the researcher using the Observation Scale of Behavioural Distress, and by the parent, doctor and child (if old enough) using a 10-cm, 100-point Visual Analogue Scale (VAS). Doctors also completed a simple rating scale for difficulty of venepuncture. Compared to older children, infants had significantly more anxious parents and were more distressed when being held still. Anticipatory anxiety correlated with higher pain ratings. No differences in the analgesic effect of the two preparations were found. We conclude that whilst EMLA and Ametop are equally effective at reducing the pain of needle puncture, under some circumstances the use of Ametop may be more advantageous.