Emla Cream for Venous Cannulation an Evaluation of the Efficacy and Timing of Application

The purpose of this study was to evaluate the efficacy and effective timing of application of EMLA 5% cream (eutectic mixture of local anaesthetic) in obtunding the pain produced by intravenous cannulation. 60 ASA I and II patients, of either sex, between 18 to 60 years, scheduled for elective surgeries were included in the study. Pregnant and lactating patients, patients allergic to study medication and patients with methemoglobinemia or on drugs that may cause it, were excluded from the study. All patients were randomly allocated by envelope method into three groups of 20 each; group A (study group I), group B (study group II), group C (control group). Patients in group A were cannulated after 30 minutes, whereas patients in group B were cannulated after 60 minutes of application of EMLA cream. In group C patients, venous cannulation was performed without EMLA cream, placebo or any occlusive dressing. Pain score was graded using 4-point scale by an independent observer. Heart rate and blood pressure were recorded before and during cannulation. Adverse reactions were also noted. The obtained data was then analyzed by chi-square test and paired ‘t’ test. Both the study groups A and B had significantly lower pain scores (group A-1.35; group B-0.15) when compared to the control group (2.5). The control group had a significant rise in heart rate and blood pressure during cannulation. We conclude that, application of EMLA cream for venous cannulation alleviated pain, prevented haemodynamic stress response to cannulation and the maximum effect was seen after an application time of 60 minutes.