Abstract
The aim the study was to determine the effect of SonoPrep® on the delivery and analgesic effects of EMLA® cream prior to intravenous (iv) cannulation in a tertiary pediatric emergency department. Children aged between 5 and 10 years were enrolled. Patients were randomized to receive either sonophoresis with SonoPrep® or sham sonophoresis followed by application of EMLA® cream for 5 min prior to iv cannulation. The primary outcome measurement was the child’s rating of pain immediately after iv placement, using a 10-cm visual analog scale (VAS). Parents or guardians and blinded researchers were additionally asked to rate their perception of the child’s pain using the 10-cm VAS and the Wong–Baker Face scale. A total of 42 patients completed the study (21 in the study group, 21 in the control group). The baseline characteristics between the groups were similar. The VAS pain score was significantly lower in children treated with sonophoresis compared with the sham sonophoresis (median (percentiles 25th–75th), 20.0 (10.0–22.5) vs. 60.0 (31.0–87.5); p < 0.001). The parent’s perception of the child’s pain was significantly lower in the study group vs. the control group by the VAS (median (percentiles 25th–75th), 10.0 (10.0–20.0) vs. 50.0 (15.0–80.0); p < 0.001) and Wong–Baker Face scale (median (percentiles 25th–75th), 2.0 (2.0–2.0) vs. 4.0 (2.5–4.5); p < 0.001). The researcher’s evaluation of the child’s discomfort was also significantly lower in the study group (2.0 (1.0–3.0) vs. 4.0 (2.5–4.5); p < 0.001). The application of sonophoresis using SonoPrep® followed by the 5-min application of EMLA® cream showed significant benefit in young children in terms of pain reduction and patient satisfaction.
Abbreviations
- iv:
-
Intravenous
- ED:
-
Emergency department
- VAS:
-
Visual analogue scale
References
Becker BM, Helfrich S, Baker E, Lovgren K, Minugh PA, Machan JT (2005) Ultrasound with topical anesthetic rapidly decreases pain of intravenous cannulation. Acad Emerg Med 12:289–295
Katz NP, Shapiro DE, Herrmann TE, Kost J, Custer LM (2004) Rapid onset of cutaneous anesthesia with EMLA cream after pretreatment with a new ultrasound-emitting device. Anesth Analg 98:371–376
Langer R (2004) Transdermal drug delivery: past progress, current status, and future prospects. Adv Drug Deliv Rev 56:557–558
Maunuksela EL, Korpela R (1986) Double-blind evaluation of a lignocaine-prilocaine cream (EMLA) in children. Effect on the pain associated with venous cannulation. Br J Anaesth 58:1242–1245
Singer AJ, Weeks R, Regev R (2006) Laser-assisted anesthesia reduces the pain of venous cannulation in children and adults: a randomized controlled trial. Acad Emerg Med 13:623–628
Skarbek-Borowska S, Becker BM, Lovgren K, Bates A, Milnugh PA (2006) Brief focal ultrasound with topical anesthetic decreases the pain of intravenous placement in children. Pediatr Emerg Care 22:339–345
Spanos S, Booth R, Koenig H, Sikes K, Gracely E, Kim IK (2008) Jet injection of 1% buffered lidocaine versus topical ELA-Max for anesthesia before peripheral intravenous catheterization in children: a randomized controlled trial. Pediatr Emerg Care 24:511–515
Tachibana K, Tachibana S (1993) Use of ultrasound to enhance the local anesthetic effect of topically applied aqueous lidocaine. Anesthesiology 78:1091–1096
Yamamoto LG, Boychuk RB (1998) A blinded, randomized, paired, placebo-controlled trial of 20-minute EMLA cream to reduce the pain of peripheral i.v. cannulation in the ED. Am J Emerg Med 16:634–636
Zempsky WT, Robbins B, McKay K (2008) Reduction of topical anesthetic onset time using ultrasound: a randomized controlled trial prior to venipuncture in young children. Pain Med 9:795–802
Zempsky WT, Sullivan J, Paulson DM, Hoath SB (2004) Evaluation of a low-dose lidocaine iontophoresis system for topical anesthesia in adults and children: a randomized, controlled trial. Clin Ther 26:1110–1119
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kim, D.K., Choi, S.W. & Kwak, Y.H. The effect of SonoPrep® on EMLA® cream application for pain relief prior to intravenous cannulation. Eur J Pediatr 171, 985–988 (2012). https://doi.org/10.1007/s00431-012-1696-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-012-1696-6