Online ISSN: 2515-8260

Efficacy of EMLA cream in attenuating pain and haemodynamic response to venous cannulation

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Dr. Anushree Shukla1 (Junior Resident 3rd Year), Dr. A. K. Babar2 (Associate Professor), Dr. Kratika Choubey3 (Junior Resident 3rd Year), Dr. Devesh Mishra4 (Junior Resident 3rd Year) & Dr. Deepak Joshi5 (Prof. & H.O.D)

Abstract

Abstract: Background & Method: The aim of this study is to observe the effect of EMLA cream on producing dermal analgesia and attenuating hemodynamic response to venous cannulation. The patients were selected randomly, from those who were posted for surgery next day. Patients were selected for study using chit/slip pick up randomization. Each day only 3 patients were selected for the study. Three chits were made one for control/placebo, one for 60 minutes, one for 90 minutes. All chits were folded and kept in blank opaque envelope. Selected three patients were asked to pick up one slip each and EMLA cream or plain patch were applied for selected duration. Cannulation was done after observing patch site and cleansing and sterilising. Result: Group A and B patients had good analgesia whereas group C patients experienced more pain. Pain on VAS was significantly higher in group C and accordingly pain relief was best seen in group A and B at the time of cannulation. It can be observed that intravenous cannulation pain was much less in group A and B. 39.1% patients of group A and 79.3% in group B experienced very less pain. Group C patients experienced mild to severe pain. 13% patients from group C had severe pain on intravenous cannulation whereas remaining 87% had mild to moderate pain. Less pain on cannulation observed in group A and group B patients in whom EMLA cream was applied is statistically significant and hemodynamic response was less in Group A and B. Conclusion: This study was carried out in 69 patients, which were divided in three groups. EMLA cream was applied in two groups, group B (23) patients for 90 minutes before cannulation and group A (23) patients 60 minutes before cannulations whereas group A (23) patients only patch was applied. Patients were assessed one day prior to surgery pre-anaesthetic check up and ASA grading was done. VAS scale was explained to the patient and best sites were selected for intravenous cannulation. On the day of surgery after applying cream, patients were closely monitored by various parameters like any change in like SBP, DBP and pulse on intravenous cannulation and after cannulation at pre-decided intervals of 5 min, 10 minutes and as pre-scheduled.

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