Pain Control in Pediatric Oncology: Utility of EMLA Cream vs Lidocaine Injection in Lumbar Punctures

OBJECTIVE: To evaluate the efficacy of eutectic mixture of local anesthetics 5% (Emla) in reducing pain associated with lumbar punctures in children. DESIGN: Prospective, double-blind, randomized, placebo-controlled trial. SETTING: University pediatric hospital. PATIENTS: Eleven pediatric oncology patients (mean age 6.6 y, range 4–16) who underwent 31 lumbar punctures. MAIN OUTCOME MEASURES: The analgesic effect was measured by using two methods. The first was a 10-point visual analog scale reported by the patient and the second was an 8-point behavioral pain scale assessed by the nurse who applied the cream. RESULTS: Emla cream was associated with significantly lower pain scores than those with placebo as measured by the patient when the puncture was successful on the first attempt (2.0 +1.6 Emla group, 3.8 +1.9 placebo group; p < 0.05). CONCLUSIONS: The use of Emla cream may reduce pain substantially only in patients who undergo a successful lumbar puncture on the first attempt.

Download Full-text

Advantages of Emla cream over lidocaine injection for radiofrequency reduction of the inferior turbinate

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2020.102850 ◽

2020 ◽

pp. 102850

Author(s):

Nurdoğan Ata

Keyword(s):

Inferior Turbinate ◽

Emla Cream ◽

Lidocaine Injection

Download Full-text

Eutectic mixture of lidocaine and prilocaine versus 1% lidocaine injection for lumbar punctures in pediatric oncology patients

Pediatric Blood & Cancer ◽

10.1002/pbc.27957 ◽

2019 ◽

Vol 66 (11) ◽

Cited By ~ 1

Author(s):

Amy Cruickshank ◽

Fares Qeadan ◽

John F. Kuttesch ◽

Hemant S. Agarwal

Keyword(s):

Pediatric Oncology ◽

Eutectic Mixture ◽

Oncology Patients ◽

Lidocaine Injection

Download Full-text

Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision

Annals of Pediatric Surgery ◽

10.1186/s43159-019-0002-z ◽

2019 ◽

Vol 15 (1) ◽

Author(s):

Olakayode O. Ogundoyin ◽

Dare I. Olulana ◽

Taiwo A. Lawal ◽

Felix O. Kumolalo

Keyword(s):

Surgical Procedures ◽

Pain Control ◽

Hospital Setting ◽

Pain Scores ◽

Lidocaine Injection ◽

Group A ◽

The Mean ◽

Neonatal Circumcision ◽

Group B ◽

Penile Block

Abstract Background Circumcision is one of the commonest surgical procedures performed yet the most controversial worldwide. Although various reasons have been suggested in support of circumcision, the pain and stress that accompany it on both neonates and mothers are factors against the procedure. This study compared pain control using oral acetaminophen syrup versus 1% lidocaine injection given as dorsal penile block during neonatal circumcision. Results There were 191 neonates in group A and 195 in group B. The mean age at circumcision was 23.71 (SD ± 20.39) days, and mean weight was 3.33 (SD ± 0.74) kg. The mean pain scores for group A immediately and 1 h after circumcision were 4.26 (SD ± 2.48) and 0.37 (SD ± 1.35), respectively. In group B, the mean pain scores immediately and 1 h after circumcision were 3.31 (SD ± 2.59) and 0.35 (SD ± 1.19), respectively. Conclusion Penile block gives better pain control in comparison with oral acetaminophen syrup, but both agents are effective and can be combined to provide a long-lasting perioperative anaesthesia and analgesia for circumcision in the hospital setting.

Download Full-text

Serial studies of ketamine narcosis (KN) for pain control in pediatric oncology

Pain ◽

10.1016/0304-3959(87)91278-4 ◽

1987 ◽

Vol 30 ◽

pp. S100

Author(s):

J. A. Leeuw ◽

A. Links ◽

A. Kingma ◽

S. S.N. de Graaf ◽

W. J. Meyler ◽

...

Keyword(s):

Pediatric Oncology ◽

Pain Control

Download Full-text

Evidence-Based Recommendations for the Appropriate Level of Sedation to Manage Pain in Pediatric Oncology Patients Requiring Procedures: A Systematic Review From the Children’s Oncology Group

Journal of Pediatric Oncology Nursing ◽

10.1177/1043454219858610 ◽

2019 ◽

Vol 37 (1) ◽

pp. 6-20 ◽

Cited By ~ 1

Author(s):

Elizabeth A. Duffy ◽

Tara Adams ◽

Clifton P. Thornton ◽

Beth Fisher ◽

Jennifer Misasi ◽

...

Keyword(s):

Systematic Review ◽

Bone Marrow ◽

Cancer Treatment ◽

Pediatric Oncology ◽

Pediatric Cancer ◽

Pain Control ◽

Systematic Search ◽

Evidence Based ◽

Oncology Group ◽

Bone Marrow Biopsies

Repeated invasive and painful procedures are often necessary components of pediatric cancer treatment. Adequate pain control during procedures is essential; however, procedure-related pain may be underestimated and undertreated. Currently, there is not a standard approach for the appropriate level of sedation to manage procedure-related pain in children with cancer. A team was assembled to review the evidence and develop recommendations to determine the appropriate level of sedation necessary for pain control in patients undergoing pediatric oncology procedures. After a systematic search of the literature, 15 research-based articles were synthesized and critically appraised. A recommendation was made related to the level of sedation utilized for bone marrow aspirates and bone marrow biopsies. There is a need for further research related to the necessary level of sedation for patients undergoing pediatric oncology procedures.

Download Full-text