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

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    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.
    Issue Date
    2012-02-03T15:13:19Z
    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
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    Metadata
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    Citation
    Can J Anaesth. 1999 Nov;46(11):1014-8.
    Journal
    Canadian journal of anaesthesia = Journal canadien d'anesthesie
    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
    ISSN
    0832-610X (Print)
    0832-610X (Linking)
    Collections
    Cork University Hospital

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