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Comparison of Two Application Techniques of EMLA and Pain Assessment in Pediatric Oncology Patients
  1. Marco Calamandrei, M.D*,
  2. Andrea Messeri, M.D*,
  3. Paolo Busoni, M.D*,
  4. Gabriella Bernini, M.D,
  5. Alma Lippi, M.D and
  6. Fabio Tucci, M.D
  1. *Anesthesia and Resuscitation Unit, A. Meyer Pediatric Hospital, and the
  2. Department of Pediatrics, Pediatric Oncohematology Unit, Università degli Studi di Firenze, Italy
  1. Reprint requests: M. Calamandrei, MD, U.O. Anestesia e Rianimazione, Ospedale Pediatrico “A. Meyer,” Via Luca Giordano 13, 50132 Florence, Italy.


Background and Objectives The study was designed to compare the analgesic efficacy of the local anesthetic EMLA when applied as a patch and as a cream in combination with a Tegaderm dressing to pediatric oncology patients undergoing repeated lumbar punctures.

Methods The analgesic effect of the two products was assessed by a continuous or discrete visual analog scale in 24 children 3-16 years old, during two lumbar punctures. Distress was rated by use of the Observational Scale of Behavioral Distress.

Results No significant differences were found between the pain and distress scores for the different preparations of EMLA.

Conclusion The EMLA patch and the EMLA cream are equally effective in alleviating pain associated with lumbar puncture. The EMLA patch simplifies and speeds up the application of EMLA. It also allows for control of the dose administered per application, thus preventing both over- and underdosing.

  • pediatric oncology
  • pain
  • lumbar puncture
  • topical analgesia
  • EMLA

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