van Kan, 1997  Title: Tetracaine versus lidocaine-prilocaine
for preventing venipuncture-induced pain in children.
Authors: van Kan HJ, Egberts AC, Rijnvos WP,
ter Pelkwijk NJ, Lenderink AW
Journal: Am J Health Syst Pharm 1997 Feb 15;54(4):388-92
PMID: 9043560, UI: 97196448
Affiliated institution: Department
of Pharmacy, Hospital Gelderse Vallei, Bennekom, Netherlands.
Cited in:
The efficacy of tetracaine cream versus that of lidocaine-prilocaine
cream for the prevention of pain in children undergoing venipuncture
was studied. Hospital inpatients 1-15 years of age received, on
the back of each hand, a 30-minute application of tetracaine 4%
cream or a 60-minute application of lidocaine-prilocaine cream
(EMLA, Astra) before undergoing scheduled venipuncture. The phlebotomists
in this open, randomized trial evaluated the efficacy of the cream
at the moment of venipuncture as adequate, inadequate, or inconclusive.
Blood samples were taken immediately after venipuncture from 10
patients one to five years of age to measure the serum concentrations
of tetracaine and its metabolite, N-butyl-p-aminobenzoic acid.
Lidocaine-prilocaine cream was significantly more efficacious
in preventing pain than tetracaine 4% cream (97% of the former
group [n = 32] had adequate pain relief, compared with 76% of
the latter [n = 34]. The only adverse effects observed were mild
local erythema in the tetracaine group and local skin blanching
in the lidocaine-prilocaine group. No tetracaine could be detected
in serum, and the serum concentrations of N-butyl-p-aminobenzoic
acid ranged from 0 to 1.8 mg/l. Statistically, lidocaine-prilocaine
cream was more efficacious than tetracaine 4% cream, but the difference
is of minor clinical significance and is outweighed by the practical
advantages of tetracaine 4% cream, namely the shorter application
time, vasodilation and lower cost.
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