Home application of EMLA cream prior to venipuncture. Is it feasible in pediatric ENT day care surgery?

EMLA (Eutectic Mixture of Local Anaesthetics) cream is an emulsion made from lidocaine and prilocaine. The cream is well known among parents in Scandinavia, and it has become most popular in preventing pain during venipuncture in children. To be fully effective the cream must be applied at least 60 min before the painful stimulus, which is a major drawback in outpatient practice. Could this problem be eliminated by home application of EMLA cream? To answer this we performed a study comprising 228 consecutive patients (1-15 years of age) planned for outpatient surgery. All parents received a letter with detailed information about the procedure and a prescription of EMLA cream. Parents and anaesthesiology nurses answered questionnaires after the operation. Twenty-three children were excluded from the study due to failure in registration or they were called in to fill vacancies. One hundred and eighty out of 205 children had EMLA cream applied. Home application of EMLA cream reduced the waiting time at the ENT outpatient clinic by at least 60 min, and the study showed that home application of EMLA cream is safe, easy to perform and a well-tolerated procedure.