Topical Anesthetics and Analgesics
73. J.G., a 6-year-old boy, is being treated for osteomyelitis of his foot as a result of a skate boarding accident. Because of the need for long-term antibiotic therapy, he requires occasional IV access replacement. He is very fearful of the procedure because of the associated pain. What can be offered to J.G. to reduce his discomfort?
Insertion of a venous catheter often produces significant discomfort and pain, but there is no reason C.T. has to endure it. Topical lidocaine–prilocaine cream (EMLA) can provide good pain relief during catheter insertion for minor surgical procedures such as circumcision and skin grafts.240,241 The cream must be applied 30 to 60 minutes before the procedure with an occlusive dressing; the anesthetic effect lasts approximately 60 to 120 minutes.242 A smaller-gauge catheter also may reduce the amount of pain associated with the venipuncture.243
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