IS LIDOCAIN-PRILOCAINE CREAM (EMLA(R)) ALWAYS USEFUL FOR VENOUS PUNCTURE IN PREOPERATIVE AUTOLOGOUS BLOOD DONATION

Purpose: The goal of the present study was to evaluate in adults the b enefit of the Eutectic Mixture of Local Anesthetics (EMLA(R) for preop erative autologous blood donation. Methods: Twenty-six adult patients requiring three blood samples were studied. The pain of venipuncture w as assessed by the patient using a 100 mm Visual Analogue Scale (VAS) and a four-category Verbal Rating Scale (VRS). The first puncture was performed without anaesthesia, as a ''reference puncture.'' The second and third punctures were performed with EMLA(R) and placebo in a doub le-blind cross-over randomization. For statistical analysis, the patie nts were allocated to two groups according to the VAS scores of the re ference puncture: (Group 1) VAS(ref) < 20 mm; Group 2) VAS(ref) greate r than or equal to 20 mm. Results: For the whole 26 patients, the VAS and the VRS pain scores were lower for EMLA(R) puncture than for both the placebo and reference punctures (P < 0.05). Twenty patients had a VAS(ref) < 20 mm and six patients a VAS(ref) greater than or equal to 20 mm. In Group 1, there was no difference between EMLA(R) and placebo for both the VAS and VRS scores. In contrast, in Group 2, the VAS sco re was lower for EMLA(R) than for both the placebo and the reference p unctures (respectively 11 +/- 7.1, 28.9 +/- 7.9, 29.1 +/- 6.4; P < 0.0 1); the VRS score was also lower for EMLA(R) puncture than for placebo puncture (P < 0.05). Conclusion: In adults requiring repeated venous punctures, pain from cannulation may be evaluated at the first punctur e with a Visual Analogue Scale, thus indicating or not the need for EM LA(R).