Comparison of the effect of local anesthetic cream

A number of studies have shown that orally administered sweet-tasting solutionsreduce feeling of pain during invasive procedures. The local anesthetic cream EMLAhas recently been shown to be safe for use in neonates. The present study aimed to comparethe pain-reducing effect of EMLA cream with that of orally administered glucose duringvenipuncturing of newborns in Yazd city. A randomized, controlled, double blind clinical trial was performed on 220 newbornsundergoing venipuncture for clinical reasons. EMLA cream was applied to the skin of106 of the newborns, along with orally administered sterile water as placebo. In addition, a30% solution of glucose was administered orally to 114 neonates whose skin was treatedwith vitamin A+D cream as placebo. Symptoms associated with pain while venipuncturingmeasured by Neonatal/ Infant pain scale (NIPS) and crying time was compared betweenthe two groups. There were no differences in background variables between the 2 groups. The resultsshowed that the NIPS scores were significantly lower in the glucose group (Median: 2)compared with the EMLA group (median: 3) (p<0.001). The duration of crying in the first 2minutes was significantly lower (p<0.01) in the glucose group (median: 2 sec) than inEMLA group (median: 9 sec). The NIP values higher than 3 were observed in 12.3% and29.2% of neonates in glucose and EMLA groups respectively, where the difference wasfound to be statistically significant (p<0.05). Our study showed that compared with EMLA cream, orally administered glucosecan be more effective, tolerable and convenient in reducing pain from venipuncturingin neonates.