Effect of EMLA cream on skin thickness and subcutaneous venous diameter. Arandomized, placebo-controlled study in children

EMLA cream, which is used to provide analgesia prior to venepuncture, induc es a skin-blanching reaction. This reaction may be caused by both skin hydr ation and vasoconstriction. Twenty healthy children with veins suitable for venepuncture on the dorsa of the hands or at the antecubital fossae had ap plied either EMLA cream or placebo cream under occlusion for 60-70 min in a randomized, double-blind, cross-over study. An ultrasound examination of t he skin was conducted. The mean percentage change in vein diameter after re moval of EMLA cream was not significant whereas, 15 min after EMLA cream re moval, the decrease in the initial vein diameter (13.5%) was significant (p <0.01). The changes in vein diameter and skin thickness due to the applicat ion of EMLA cream do not seem to be of clinical importance to vein cannulat ion.