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a Department of Paediatrics, Peterborough
District Hospital, b Department of Epidemiology and
Public Health, University of Leicester
Correspondence to: Dr R M Beattie Peterborough District Hospital Thorpe Road Peterborough PE3 6DA.
Accepted 25 September 1997
AIM
To assess the safety and efficacy of EMLA
cream (eutectic mixture of local anaesthetics) used to induce surface
anaesthesia for venepuncture in healthy preterm infants.
METHODSNineteen infants, median gestational age
31 weeks (range 26-33 weeks) were assessed in a randomised, double
blind, placebo controlled, cross-over trial. Changes in physiological
variables (heart rate, blood pressure, oxygen saturation) and
behavioural responses (neonatal facial coding system score, crying
time) before and after venepuncture with EMLA cream were compared with
those obtained with a placebo cream to assess efficacy. Toxicity was assessed by comparing methaemoglobin concentrations at 1 hour and 8 hours after application.
RESULTSThere was no significant difference in
efficacy between EMLA and placebo creams in physiological and
behavioural responses. There was no significant difference in
methaemoglobin concentrations one hour after the cream had been
applied. At eight hours, however, concentrations were significantly
higher after EMLA than placebo (p=0.016). There was no evidence of
clinical toxicity.
CONCLUSIONThis study does not support the routine
use of EMLA for venepuncture in healthy preterm infants.
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