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

Background The role of local analgesics for lumbar punctures (LPs) in pediatric oncology patients has not been specifically studied. Aim To compare the efficacy of eutectic mixture of local anesthetics (EMLA) cream to 1% lidocaine injection for LPs. Method This was a retrospective observational stud...

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Bibliographic Details
Published in:Pediatric blood & cancer 2019-11, Vol.66 (11), p.e27957-n/a
Main Authors: Cruickshank, Amy, Qeadan, Fares, Kuttesch, John F., Agarwal, Hemant S.
Format: Article
Language:English
Subjects:
Administration, Cutaneous
Analgesics
Analgesics - administration & dosage
Anesthetics
Anesthetics, Local - administration & dosage
Child
Cream
Demographics
Demography
EMLA cream
Female
Fentanyl
Fentanyl - administration & dosage
Hematology
Humans
Hypnotics and Sedatives - administration & dosage
Injection
Injections, Intravenous
Injections, Subcutaneous
Lidocaine
Lidocaine, Prilocaine Drug Combination - administration & dosage
Local anesthesia
local anesthetic
Local anesthetics
lumbar puncture
Male
Ointments
Oncology
Pain
Pain, Procedural - etiology
Pain, Procedural - prevention & control
pediatric oncology
Pediatrics
Prilocaine
procedural sedation
Propofol
Propofol - administration & dosage
Recovery time
Spinal Puncture - adverse effects
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Summary:Background The role of local analgesics for lumbar punctures (LPs) in pediatric oncology patients has not been specifically studied. Aim To compare the efficacy of eutectic mixture of local anesthetics (EMLA) cream to 1% lidocaine injection for LPs. Method This was a retrospective observational study of all patients receiving either EMLA cream (EMLA group) or 1% lidocaine subcutaneous injection (lidocaine group) in addition to fentanyl and propofol for LPs over 18 months. Demographics, vital parameters, procedural and recovery times, propofol and fentanyl doses, and adverse events were studied. Results Two hundred ninety LPs in 49 children were studied: 148 in the EMLA group and 142 in the lidocaine group. There was no difference in demographics or preprocedural parameters between the two groups. LPs in the EMLA group were completed in a shorter time (7.5 minutes [CI 7.0–8.1] vs 9.4 minutes [CI 8.9–9.9]) with a faster recovery time (38.7 minutes [CI 36.9–40.9] vs 43.9 minutes. [CI 41.9–45.9]) as compared with the lidocaine group (P 
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.27957