Topical amethocaine (Ametop) is superior to EMLA for intravenous cannulation. Eutectic mixture of local anesthetics.

Hdl Handle:
http://hdl.handle.net/10147/209140
Title:
Topical amethocaine (Ametop) is superior to EMLA for intravenous cannulation. Eutectic mixture of local anesthetics.
Authors:
Browne, J; Awad, I; Plant, R; McAdoo, J; Shorten, G
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Wilton, Ireland.
Citation:
Can J Anaesth. 1999 Nov;46(11):1014-8.
Journal:
Canadian journal of anaesthesia = Journal canadien d'anesthesie
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209140
PubMed ID:
10566919
Abstract:
PURPOSE: A eutectic mixture of local anesthetics (EMLA) is commonly used to provide topical anesthesia for intravenous (i.v.) cannulation. One of its side effects is vasoconstriction, which may render cannulation more difficult. A gel formulation of amethocaine (Ametop) is now commercially available. The aim of this study was to compare EMLA and Ametop with regard to the degree of topical anesthesia afforded, the incidence of vasoconstriction and the ease of i.v. cannulation. METHODS: Thirty two ASA I adult volunteers had a #16 gauge i.v. cannula inserted on two separate occasions using EMLA and Ametop applied in a double blind fashion for topical anesthesia. Parameters that were recorded after each cannulation included visual analogue pain scores (VAPS), the presence of vasoconstriction and the ease of cannulation, graded as: 1 = easy, 2 = moderately difficult, 3 = difficult and 4 = failed. RESULTS: The mean VAPS +/- SD after cannulation with Ametop M was 12+/-9.9 and with EMLA was 25.3+/-16.6 (P = 0.002). Vasoconstriction occurred after EMLA application on 17 occasions and twice after Ametop (P = 0.001). The grade of difficulty of cannulation was 1.44+/-0.88 following EMLA and 1.06+/-0.25 with Ametop (P = 0.023). CONCLUSIONS: Intravenous cannulation was less painful following application of Ametop than EMLA. In addition, Ametop caused less vasoconstriction and facilitated easier cannulation. Its use as a topical anesthetic agent is recommended, especially when i.v. access may be problematic.
Language:
eng
MeSH:
Administration, Topical; Adult; Anesthetics, Local/adverse effects/*pharmacology; *Catheterization, Peripheral; Double-Blind Method; Humans; Lidocaine/*pharmacology; Prilocaine/*pharmacology; Prospective Studies; Tetracaine/administration & dosage/adverse effects/*pharmacology; Vasoconstriction/drug effects
ISSN:
0832-610X (Print); 0832-610X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBrowne, Jen_GB
dc.contributor.authorAwad, Ien_GB
dc.contributor.authorPlant, Ren_GB
dc.contributor.authorMcAdoo, Jen_GB
dc.contributor.authorShorten, Gen_GB
dc.date.accessioned2012-02-03T15:13:19Z-
dc.date.available2012-02-03T15:13:19Z-
dc.date.issued2012-02-03T15:13:19Z-
dc.identifier.citationCan J Anaesth. 1999 Nov;46(11):1014-8.en_GB
dc.identifier.issn0832-610X (Print)en_GB
dc.identifier.issn0832-610X (Linking)en_GB
dc.identifier.pmid10566919en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209140-
dc.description.abstractPURPOSE: A eutectic mixture of local anesthetics (EMLA) is commonly used to provide topical anesthesia for intravenous (i.v.) cannulation. One of its side effects is vasoconstriction, which may render cannulation more difficult. A gel formulation of amethocaine (Ametop) is now commercially available. The aim of this study was to compare EMLA and Ametop with regard to the degree of topical anesthesia afforded, the incidence of vasoconstriction and the ease of i.v. cannulation. METHODS: Thirty two ASA I adult volunteers had a #16 gauge i.v. cannula inserted on two separate occasions using EMLA and Ametop applied in a double blind fashion for topical anesthesia. Parameters that were recorded after each cannulation included visual analogue pain scores (VAPS), the presence of vasoconstriction and the ease of cannulation, graded as: 1 = easy, 2 = moderately difficult, 3 = difficult and 4 = failed. RESULTS: The mean VAPS +/- SD after cannulation with Ametop M was 12+/-9.9 and with EMLA was 25.3+/-16.6 (P = 0.002). Vasoconstriction occurred after EMLA application on 17 occasions and twice after Ametop (P = 0.001). The grade of difficulty of cannulation was 1.44+/-0.88 following EMLA and 1.06+/-0.25 with Ametop (P = 0.023). CONCLUSIONS: Intravenous cannulation was less painful following application of Ametop than EMLA. In addition, Ametop caused less vasoconstriction and facilitated easier cannulation. Its use as a topical anesthetic agent is recommended, especially when i.v. access may be problematic.en_GB
dc.language.isoengen_GB
dc.subject.meshAdministration, Topicalen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnesthetics, Local/adverse effects/*pharmacologyen_GB
dc.subject.mesh*Catheterization, Peripheralen_GB
dc.subject.meshDouble-Blind Methoden_GB
dc.subject.meshHumansen_GB
dc.subject.meshLidocaine/*pharmacologyen_GB
dc.subject.meshPrilocaine/*pharmacologyen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshTetracaine/administration & dosage/adverse effects/*pharmacologyen_GB
dc.subject.meshVasoconstriction/drug effectsen_GB
dc.titleTopical amethocaine (Ametop) is superior to EMLA for intravenous cannulation. Eutectic mixture of local anesthetics.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Wilton, Ireland.en_GB
dc.identifier.journalCanadian journal of anaesthesia = Journal canadien d'anesthesieen_GB
dc.description.provinceMunster-
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