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Amethocaine-Lidocaine Cream, a New Topical Formulation for Preventing Venopuncture-Induced Pain in Children
  1. María Dolores Cárceles,
  2. José María Alonso,
  3. Martin García-Muñoz,
  4. María Dolores Nájera,
  5. Isabel Castaño and
  6. Nieves Vila
  1. From the Departments of Anesthesiology and Pharmacology, “Virgen de la Arrixaca” University Hospital, General University Hospital and “Morales Meseguer” General Hospital, Murcia, Spain.
  1. Reprint requests: Martín García-Muñoz, M.D., Paseo Fotógrafo Verdu, n° 2, Pta. 12, 30002 Murcia, Spain. E-mail:


Background and Objectives The aim of this study was to compare the effectiveness of 3 anesthetic creams in relieving venous puncture-related pain in children.

Methods We performed a double-blind, randomized, prospective study in 300 patients, American Society of Anesthesiologists (ASA) I-II, aged 3 months to 10 years, scheduled for minor elective surgical procedures. These children were distributed into 3 groups, with 100 patients each, according to each type of cream applied to the back of the children’s hands before performing the venous puncture: Group I was given EMLA (eutectic 2.5% lidocaine and 2.5% prilocaine mixture), group II received 4% amethocaine (4% AMET), and group III was treated with AMLI (2.5% amethocaine and 2.5% lidocaine), a new anesthetic cream developed at our hospital. Each group was further classified into 5 subgroups, with 20 patients each, according to the time length of the application of the individual cream (group A, ≤ 30 minutes; B, 30 minutes to 60 minutes; C, 60 minutes to 90 minutes; D, 90 minutes to 120 minutes; E, ≥ 120 minutes). We evaluated pain, movement, and verbalization to puncture, as well as the appearance of adverse effects.

Results Group I (EMLA), subgroup A (≤ 30 minutes), experienced significantly more pain, movement, and verbalization than groups II and III. Patients in group II (4% AMET) exhibited a higher frequency of untoward effects.

Conclusions All 3 creams proved to be effective in relieving venous puncture pain in children. EMLA presented a longer latency period, 4% amethocaine showed the highest percentage of untoward effects, and AMLI exhibited a shorter latency period than EMLA, while having fewer adverse effects than 4% AMET and EMLA.

  • Topical anesthesia
  • Lidocaine
  • Prilocaine
  • Amethocaine
  • EMLA

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