Effect of eutectic mixture of local anesthetics (EMLA) for pain relief during suprapubic aspiration in young infants: a randomized, controlled trial.

Author(s): Nahum Y, Tenenbaum A, Isaiah W, Levy-Khademi F

Affiliation(s): Department of Pediatrics, Hadassah University Hospital, Mount Scopus Campus, Jerusalem, Israel.

Publication date & source: 2007-11, Clin J Pain., 23(9):756-9.

OBJECTIVES: The purpose of this study was to determine whether a eutectic mixture of local anesthetics (EMLA) cream reduce the pain experienced by newborns and young infants undergoing suprapubic aspiration (SPA). METHODS: A single-center, randomized, placebo-controlled, double-blind, prospective study including 52 infants 1 to 60 days of age undergoing SPA to obtain urine for culture. Twenty-four infants were randomly assigned to receive 1-g EMLA cream 1 hour before the procedure, whereas 28 were randomly assigned to receive placebo cream 1 hour before the planned procedure. Pain symptoms were measured using the Premature Infant Pain Profile (PIPP). RESULTS: The mean PIPP scores were significantly lower in the EMLA group compared with the placebo group (8.90+/-3.04 vs. 10.46+/-2.29; P=0.038). There were significantly fewer patients in the EMLA group who were scored as having some degree of pain (defined as PIPP score >6) in comparison with the placebo group (70% vs. 96%; P=0.025). DISCUSSION: Newborns and infants undergoing SPA experience pain during the procedure. Application of EMLA cream 1 hour before SPA is effective in reducing the pain associated with SPA. In situations in which an SPA is not emergent, strong consideration should be given to the use of EMLA.