Topical amethocaine gel in the newborn infant: how soon does it work and how long does it last?
A Jain, N Rutter
Department of
Neonatal Medicine, Nottingham City Hospital, Hucknall Road, Nottingham
NG5 1PB, UK
Correspondence to: Dr Jain email: anoo.jain{at}nottingham.ac.uk
Accepted 15 May 2000
AIM
To explore the
time of onset and duration of action of topical amethocaine gel in the
newborn infant.
DESIGNA randomised
double blind placebo controlled trial.
SUBJECTSThirty six
infants were studied after 30 minutes application and 36 after 60 minutes application. A total of 56 infants (gestation 27-42 weeks,
weight 0.79-4.1 kg) were studied in the first two weeks after delivery.
METHOD1.5 g
amethocaine or placebo was applied to the dorsum of either foot,
occluded, and then left for 30 or 60 minutes. Local anaesthesia was
assessed by observing the cutaneous withdrawal response to graded nylon
filaments (von Frey hairs). If there was a difference between feet in
filament thickness required to elicit a response, the infant was
studied in an identical manner at hourly intervals until the difference
had disappeared.
RESULTSEvidence of
local anaesthetic action of amethocaine was seen in 23 of 36 (64%)
infants after 30 minutes and 26 of 36 (72%) infants after 60 minutes
application (no significant difference). Evidence of local anaesthetic
action was independent of gestation and order of testing. Amethocaine
responders showed a significantly deeper anaesthetic action than
placebo responders. The median duration of action was 1.5 hours (range
0.5-3.5) after 30 minutes and three hours (range 1-5) after 60 minutes (p < 0.001).
CONCLUSIONTopical
amethocaine gel has a local anaesthetic action after 30 minutes
application, but application for 60 minutes results in longer duration
of action.
Keywords: anaesthesia; amethocaine; pain
© 2000 by Archives of Disease in Childhood
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