Local anaesthetic effect of topical amethocaine gel in neonates: randomised controlled trial
Anoo Jain, Nicholas Rutter
Department of
Neonatal Medicine, Nottingham City Hospital,
Nottingham NG5 1PB
Correspondence to: Dr A Jain anoo.jain{at}nottingham.ac.uk
Accepted 31 July
1999
AIM
To assess the
efficacy of amethocaine as a topical local anaesthetic in neonates.
METHODSA randomised,
double blind controlled trial compared 4% amethocaine gel (Ametop)
with placebo in 60 healthy neonates (29 to 42 weeks of gestation) in
the first week after birth. Either 1.5 g 4% w/w amethocaine (gel) or
1.5g placebo gel were applied to the dorsum of one foot. No gel was
applied to the other foot. Each foot was occluded and left for one
hour. Local anaesthesia was then assessed by eliciting the cutaneous
withdrawal reflex in response to stimulation with a series of graded
nylon filaments (von Frey hairs). The reflex was first elicited from
the control and then the treated foot. The difference in filament
thickness and deforming weight required to elicit the reflex was recorded.
RESULTSIn infants
treated with amethocaine, 17 of 31 (54.8%) showed evidence of local
anaesthetic action compared with five of 29 (17.2%) in the placebo
group (p=0.003). The mean difference in deforming weight required to
elicit the reflex was 18.8 g in the amethocaine group compared with 3.9 g in the placebo group (p=0.02). The apparent local anaesthetic action
of the placebo can be explained by habituation to repeated stimulation.
CONCLUSIONSIt is
concluded that topical amethocaine gel has a local anaesthetic action
on neonatal skin which merits further investigation. An effective and
safe surface local anaesthetic would be valuable for the relief of
procedure related pain in neonates.
Keywords: amethocaine gel; pain; anaesthesia
© 2000 by Archives of Disease in Childhood
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Arevalo, M. I., Escribano, E., Calpena, A., Domenech, J., Queralt, J.
(2004). Rapid Skin Anesthesia Using a New Topical Amethocaine Formulation: A Preclinical Study. Anesth. Analg.
98: 1407-1412
[Abstract] [Full Text] -
Mathew, P J, Mathew, J L
(2003). Assessment and management of pain in infants. Postgrad. Med. J.
79: 438-443
[Abstract] [Full Text] -
Fitzgerald, M., Beggs, S.
(2001). Book Review: The Neurobiology of Pain: Developmental Aspects. Neuroscientist
7: 246-257
[Abstract] -
Jain, A, Rutter, N, Ratnayaka, M
(2001). Topical amethocaine gel for pain relief of heel prick blood sampling: a randomised double blind controlled trial. Arch. Dis. Child. Fetal Neonatal Ed.
84: 56F-59
[Abstract] [Full Text] -
HEATON, P., HERD, D.
(2000). Neonatal pain relief. Arch. Dis. Child. Fetal Neonatal Ed.
83: 74F-74
[Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
