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Lookup NU author(s): Professor Nick Girdler
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Objectives To compare the effect of topical skin anaesthetic agents on the discomfort and anxiety associated with venous cannulation. Design Randomised, double-blind, placebo-controlled, within subject, volunteer trial. Methods 20 healthy volunteers underwent venous cannulation on three separate occasions having received topical skin application of either 4% amethocaine gel (Ametop), 5% eutectic mixture of lidocaine and prilocaine (EMLA) or E45 cream (placebo). Visual analogue and verbal rating scales were used to assess pain and anxiety associated with the venous cannulation, and anticipated anxiety for future cannulation, under each drug condition. Results Subjects were aged 22-53 years (mean 32.8 years). The mean visual analogue scores (VAS) for discomfort were found to be significantly lower (p<0.001) with Ametop (VAS = 18mm) and EMLA (VAS = 29mm) compared with the control (VAS = 38mm). There was a positive correlation (R2 = 72%, p<0.001) between discomfort and the predicted anxiety if cannulation was to be repeated with the same cream. With the placebo a positive correlation (R2 = 19.8%, p = 0.05) was found between the level of anxiety before cannulation and the level of discomfort recorded. Conclusions Ametop and EMLA topical anaesthetic agents produce effective skin analgesia for venous cannulation. The use of topical analgesia can reduce perceived anxiety about future cannulation procedures. This has application in the management of anxious patients undergoing intravenous sedation, suggesting that topical analgesia prior to venous cannulation may significantly aid anxiolysis. © British Dental Journal.
Author(s): Speirs AF, Taylor KH, Joanes DH, Girdler NM
Publication type: Article
Publication status: Published
Journal: British Dental Journal
ISSN (print): 0007-0610
ISSN (electronic): 1476-5373
Publisher: Nature Publishing Group
PubMed id: 11352393