USE OF A EUTECTIC MIXTURE OF LOCAL-ANESTHESIA FOR CARDIAC-CATHETERIZATION IN CHILDREN

This study was designed to determine whether use of EMLA (Astra, USA, Inc.), a eutectic mixture of local anesthesia in the form of 5% cream (2.5% Prilocaine and 2.5% lidocaine), decreased the pain associated wi th local lidocaine infiltration for the placement of femoral venous an d arterial catheters during pediatric cardiac catheterization. Patient s often relate that local lidocaine infiltration is the most unpleasan t aspect of the cardiac catheterization experience. Twenty patients we re enrolled in a randomized blinded control trial in a pediatric cardi ology outpatient catheterization laboratory. All patients served as th eir own control. Pain response was evaluated using a recognized subjec tive scale from 1 to 5, with 1 being no response and 5 being crying. T wenty patients with a median age of 5 years (range, 6 months-17 years) were studied. In 18 of the 20 patients, subjective pain response was less in the EMLA cream-treated group, with no difference in the remain ing two patients. Average pain response score was 2.2 in the treated g roin and 4.05 in the untreated groin. The two groups (treated and nont reated groin) were significantly different to a p value of 0.01. A eut ectic mixture of local anesthesia was effective in reducing the pain a ssociated with local lidocaine infiltration. This new method of ''pain less'' local anesthesia is a useful adjuvant for cardiac catheterizati on and femoral vascular access in children.