Anesthetic efficacy of eutectic prilocaine-lidocaine cream in pediatric oncology patients undergoing lumbar puncture.

OBJECTIVE

To evaluate the efficacy of eutectic mixture of local anesthetics 5% (Emla) in reducing pain associated with lumbar punctures in children.

DESIGN

Prospective, double-blind, randomized, placebo-controlled trial.

SETTING

University pediatric hospital.

PATIENTS

Eleven pediatric oncology patients (mean age 6.6 y, range 4-16) who underwent 31 lumbar punctures.

MAIN OUTCOME MEASURES

The analgesic effect was measured by using two methods. The first was a 10-point visual analog scale reported by the patient and the second was an 8-point behavioral pain scale assessed by the nurse who applied the cream.

RESULTS

Emla cream was associated with significantly lower pain scores than those with placebo as measured by the patient when the puncture was successful on the first attempt (2.0 +/- 1.6 Emla group, 3.8 +/- 1.9 placebo group; p < 0.05).

CONCLUSIONS

The use of Emla cream may reduce pain substantially only in patients who undergo a successful lumbar puncture on the first attempt.