CC BY-NC-ND 4.0 · Avicenna J Med 2022; 12(04): 178-181
DOI: 10.1055/s-0042-1758389
Brief Report

Comparison of EMLA Cream versus Lidocaine Injection for Lumbar Puncture Pain Control in Pediatric Oncology Patients

Andrea D. Merry-Sperry*
1   Department of Pediatrics, West Virginia University-Charleston/Charleston Area Medical Center, Charleston, West Virginia, United States
,
Elham Alqudah*
1   Department of Pediatrics, West Virginia University-Charleston/Charleston Area Medical Center, Charleston, West Virginia, United States
,
Alexa Magner
2   School of Medicine, West Virginia University, Medicine, Morgantown, West Virginia, United States
,
Stephanie Thompson
3   Institute for Academic Medicine Charleston Area Medical Center, Charleston, West Virginia, United States
,
Pamela Smith
4   Department of Pediatric Hematology/Oncology, West Virginia University-Charleston/Charleston Area Medical Center, Charleston, West Virginia, United States
,
Ashley Meyer
4   Department of Pediatric Hematology/Oncology, West Virginia University-Charleston/Charleston Area Medical Center, Charleston, West Virginia, United States
,
4   Department of Pediatric Hematology/Oncology, West Virginia University-Charleston/Charleston Area Medical Center, Charleston, West Virginia, United States
› Author Affiliations
Funding No sponsorship or funding received.

Abstract

Background Subcutaneous lidocaine injection and topical EMLA cream are both used to control lumbar puncture (LP) pain; however, local analgesia usage is not standardized.

Methods We conducted a prospective, single-blinded, randomized-controlled crossover trial comparing the two modalities in reducing LP pain. Pediatric patients requiring serial LPs were randomly assigned to receive EMLA cream or lidocaine injection prior to LP. On the subsequent LP, analgesia was defaulted to the other agent. Pain was assessed using the Wong-Baker FACES Pain Rating Scale pre-procedure: 30 to 60 minutes post-LP, and 24 hours post-procedure.

Results Ten patients were included in the analysis (median age: 5.5 years). Pain ratings at 1 and 24 hours post-LP did not differ between the two strategies (p = 0.79). No adverse local reactions were reported for either agent.

Conclusion Accordingly, both lidocaine and EMLA cream provided effective LP pain control.

Note

The protocol was approved by our Institutional Review Board and registered at clinicaltrials.gov (NCT04003012). Link: https://clinicaltrials.gov/ct2/show/NCT04003012.


Manuscript authors included Andrea D Merry-Sperry DO, Elham Alqudah MD, Alexa Magner, Stephanie Thompson PhD, Pamela Smith APRN, Ashley Meyer DO, and Mohamad Badawi MD with each contributing to the conceptualization and design the study as well as data analysis or manuscript preparation. All authors have reviewed and agreed upon the final manuscript content. This manuscript has not been submitted elsewhere nor been previously published.


All authors declare that there are no financial interests, or other relationships of a commercial nature to disclose.


* These authors contributed equally




Publication History

Article published online:
21 December 2022

© 2022. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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