Comparison of Effect of EMLA Cream and Local Application of Cooling during Venipuncture in Children

Wednesday, 9 July 2008
Hoshang Alijany Renany, MS , Nursing and Midwifery School, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran

Learning Objective 1: reduce the pain in child who vaccinate

Learning Objective 2: reduce stress of parents


Back ground: Venipuncture is commonly seen as one of the most painful procedures. Nurses are obligated to minimize the emotional and physical effects of painful procedures.

Aim: The purpose of this clinical trial study was to comparing of EMLA cream effectiveness and local application of cooling on the venipuncture pain in children. The subjects were children in Sijoval Medical –Health Center in the City of Bandar Turkmen and aged 7-11 primary school girls.

Method: In this randomized study 75 grills 7 to 11 years old were divided into three equal groups(control,local cool,EMLA).In The EMLA group 45 minutes before venipuncture, used 1.5 gr EMLA cream on the puncture site with tegaderm dressing, in The local cool group 3 minutes before procedure , the puncture site was cooled with an ice bag enveloped in a proper cloth, and in control group not used EMLA and local cool.Then 5 minutes after blood sampling, pain intensity measured by numeric Oucher scale in three groups.

Findings: In this study, 48% of control group children have reported middle pain during venipuncture.Mean Oucher scale scores were significantly lower in the EMLA group(M=21.20)than the control group(M=56.40),and in the local cool group(M=19.60)than the control group(M=56.40).Statistically there was not significant difference in pain intensity between EMLA and local cool (P>0.05).There were significant differences in pain intensity between EMLA and control groups(P<0.05),and between control and local cool groups (P<0.05).

Conclusion: Both EMLA and local cool decreased pain intensity of venipucture.Regarding to the equal effects of EMLA and local cool, the use of local cool (ice) before venipucture is recommended. The reasons are simple, safe, easy to use, inexpensive and an effective intervention for reduction of venipuncture pain in children.