Does topical Amethocaine cream increase first-time successful cannulation in children compared with a eutectic mixture of local anaesthetics (EMLA) cream? A systematic review and meta-analysis of randomised controlled trials

  title={Does topical Amethocaine cream increase first-time successful cannulation in children compared with a eutectic mixture of local anaesthetics (EMLA) cream? A systematic review and meta-analysis of randomised controlled trials},
  author={Alison Pywell and Andreas Xyrichis},
  journal={Emergency Medicine Journal},
  pages={733 - 737}
Background Cannulation of children is often required for administration of intravenous fluids and medications, but can cause pain and anxiety. Amethocaine and a eutectic mixture of local anaesthetics (EMLA) cream are two of the most commonly used local anaesthetic creams. Objective To examine the evidence for the superiority of Amethocaine cream compared with EMLA cream in facilitating successful first-time cannulation in children. Method A systematic search was undertaken in MEDLINE and EMBASE… 
First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream
This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocane and prilocaine (EMLA) cream.
A randomized trial of iPad distraction to reduce children's pain and distress during intravenous cannulation in the paediatric emergency department.
iPad distraction during IV cannulation in school-aged children was not associated with less pain or distress than standard care alone, and the effects of iPad distraction may have been blunted by topical anesthetic cream usage.
A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation
This review examines the evidence related to pain and distress management during venepuncture and peripheral intravenous cannulation, including preparing the environment, assessing and preparing patients, parental involvement and psychological and pharmacological interventions.
Nanotechnology approaches for pain therapy through transdermal drug delivery.
The present review is proposing to summarize the recent literature on the pharmacotherapeutic principles of local anesthetics and non-steroidal anti-inflammatory drugs, generally used to alleviate pain but also the drugs as nanoformulations with potential applications in transdermal delivery.


Amethocaine versus EMLA for successful intravenous cannulation in a children’s emergency department: a randomised controlled study
A parallel, randomised, double-blind controlled study performed in children aged 3 months to 15 years who were offered topical anaesthesia for venous cannulation to determine if amethocaine improves the success of cannulation compared with EMLA.
EMLA and amethocaine for reduction of children's pain associated with needle insertion.
Although EMLA is an effective topical anaesthetic for children, amethocaine is superior in preventing pain associated with needle procedures, and a meta-analysis was done on anaesthetic efficacy, ease of needle procedure and resultant skin changes.
Topical anaesthesia and intravenous cannulation success in paediatric patients: a randomized double-blind trial.
No difference exists in the cannulation success rates between the two anaesthetics and the choice of topical anaesthetic in paediatric cannulation should be based on other factors such as cost, time to anaesthesia, efficacy of the agent, and adverse effect profile.
Cost benefit analysis of amethocaine (Ametop) compared with EMLA for intravenous cannulation in a children's emergency department
Use of amethocaine in a mixed model in the CED could reduce cost and increase the proportion of children receiving topical anaesthetic during insertion of IVC.
Comparison of lignocaine‐prilocaine cream and amethocaine gel for local analgesia before venepuncture in children
It is concluded that whilst EMLA and Ametop are equally effective at reducing the pain of needle puncture, under some circumstances the use of Ametops may be more advantageous.
Tetracaine gel vs EMLA cream for percutaneous anaesthesia in children.
Tetracaine gel provided effective, rapid, long-lasting and safe local anaesthesia, and was significantly better than EMLA cream in reducing pain during venous cannulation in children using the recommended application periods for both formulations.
[Topical anesthesia before vascular access in children. Comparison of a warmth-producing lidocaine-tetracaine patch with a lidocaine-prilocaine patch].
After a contact time of 35 min the Rapydan patch led to superior analgesia during venous puncture than the EMLA patch; with regard to visibility of the veins and success rate of the punctures, differences between the two patches were not observed.
Tetracaine versus lidocaine-prilocaine for preventing venipuncture-induced pain in children.
The efficacy of tetracaine cream versus that of lidocaine-prilocaine cream for the prevention of pain in children undergoing venipuncture was studied. Hospital inpatients 1-15 years of age received,
Consequences of inadequate analgesia during painful procedures in children.
Inadequate analgesia for initial procedures in young children may diminish the effect of adequate analgesia in subsequent procedures, and this difference is statistically significant in children younger than 8 years.
A comparison of local anaesthetics for venepuncture
Both anaesthetic agents produced adequate analgesia, however, Ametop gel was more effective, with a statistically significant difference in the pain scores of the two groups (p < 0.05).