A randomized, double‐blind comparison study of EMLA® and ELA‐Max® for topical anesthesia in children undergoing intravenous insertion

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Abstract
Background : Topical anesthetics may help reduce discomfort associated with procedures involving needle‐puncture, such as intravenous (i.v.) insertions, in children. EMLA® cream has become a common, noninvasive therapy for topical anesthesia in children. ELA‐Max® is a recently introduced topical anesthetic cream marketed as being as effective in producing topical anesthesia after a 30‐min application as EMLA® is after a 60‐min application. The purpose of this research was to compare ELA‐Max® at 30 min with EMLA® at 60 min for providing topical anesthesia for i.v. insertions in children. Methods : Sixty children, ages 8–17 years, requiring an i.v. were randomized to receive either the 30 min application of ELA‐Max® (n = 30) or the 60 min application of EMLA® (n = 30). Children rated any pain associated with the i.v. insertion using a 100‐mm Visual Analog Scale (VAS). The anesthesiologist assessed the presence of blanching at the site and rated the difficulty of placing the i.v. Results : There was no clinically or statistically significant difference in pain ratings (P = 0.87) between the ELA‐Max® (mean = 25.7) and the EMLA® (mean = 26.8) groups. ELA‐Max® caused significantly (P = 0.04) less blanching than EMLA®, however there was no difference in the anesthesiologists’ rating of the difficulty of the i.v. placement between the groups (P = 0.73). Conclusion : Results from this study support the claim that a 30‐min application of ELA‐Max® (with occlusion) is as effective as a 60‐min application of EMLA® (with occlusion) for producing topical anesthesia for i.v. insertion in children.