Document Detail


Management of pain from heel lance with lidocaine-prilocaine (EMLA) cream: is it safe and efficacious in preterm infants?
MedLine Citation:
PMID:  10475595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hospitalized preterm infants undergo multiple painful heel lances. A two-phase, randomized, controlled trial was undertaken to determine the safety and efficacy of lidocaine-prilocaine 5% cream (EMLA, Astra Pharmaceuticals, L.P, Westborough, MA) for relieving pain from heel lance. One hundred twenty infants were randomly assigned to receive 0.5 g of EMLA or placebo cream for 30 minutes (Phase 1) or 60 minutes (Phase 2) before a routine heel lance. Efficacy was assessed using the Premature Infant Pain Profile (PIPP). Safety was determined by methemoglobin concentration 8 hours after EMLA application and by clinical signs of methemoglobinemia. No significant differences existed on PIPP scores between EMLA and placebo groups in Phase 1 (p < .480) or Phase 2 (p < .831). No infant had any clinical signs of methemoglobinemia. The mean methemoglobin concentration was 1.19% (.47). Approximately 10% of infants had minor skin reactions, and approximately 20% of EMLA-treated infants had blanching at the application site. The authors conclude that EMLA is safe but not efficacious for relieving pain from heel lance in preterm infants.
Authors:
B Stevens; C Johnston; A Taddio; A Jack; J Narciso; R Stremler; G Koren; J Aranda
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of developmental and behavioral pediatrics : JDBP     Volume:  20     ISSN:  0196-206X     ISO Abbreviation:  J Dev Behav Pediatr     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-30     Completed Date:  1999-09-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006933     Medline TA:  J Dev Behav Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  216-21     Citation Subset:  IM    
Affiliation:
Faculties of Nursing and Medicine, University of Toronto, Department of Pediatrics, The Hospital for Sick Children, Ontario, Canada. bonnie.stevens@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Combined / administration & dosage*,  adverse effects
Anesthetics, Local / administration & dosage*,  adverse effects
Heel / injuries*
Humans
Infant, Newborn
Infant, Premature
Lidocaine / administration & dosage*,  adverse effects
Methemoglobinemia / blood
Pain / etiology,  prevention & control*
Prilocaine / administration & dosage*,  adverse effects
Punctures / adverse effects*
Chemical
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Local; 0/EMLA; 137-58-6/Lidocaine; 721-50-6/Prilocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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