Comparison of analgesic effects of alkalinized 2.46% lidocaine versus 5% EMLA cream applied topically before phlebotomy

Abstract

Background & objective: Phlebotomy or venipuncture is a procedure that can cause moderate to severe pain in patients. This pain can be prevented with pharmacological and/or non-pharmacological methods. One of the pharmacological methods to reduce pain is local application of local anesthetic preparation. Topical lidocaine and Eutectic Mixture of Local Anesthetics (EMLA) cream containing 2.5% lidocaine and 2.5% prilocaine are local anesthetics that can be applied before phlebotomy. We compared alkalinized 2.46% lidocaine with 5% EMLA cream on the intensity of pain on venipuncture.

Methodology: This study used the analytical pre-experimental (pre-experiment) Randomized Control Trial (RCT) method with a group pretest-posttest design approach. The study measured the intervention by comparing the EMLA 5% group with the 2.64% lidocaine group. Lidocaine was alkalinized in 70% alcohol. Both drugs were applied topically before phlebotomy, and the numeric rating scales (NRS) were compared in student volunteers of the Medical Faculty of Pattimura University, Ambon, Maluku, Indonesia.

Results: The analysis of 20 paired respondents who were given a solution of 2.64% lidocaine alkalinized in 70% alcohol topically before phlebotomy on the first day and 5% EMLA cream topically before phlebotomy on the 10th day showed very significant results with P = 0.002.

Conclusion: The application of 5% EMLA cream topically has a greater analgesic effect, compared to 2.64% lidocaine alkalinized in 70% alcohol, when measured with NRS.

Abbreviations: EMLA: Eutectic Mixture of Local Anesthetics, RCT: Randomized Control Trial, NRS: Numeric Rating Scale, IASP: International Association for Study of Pain, VRS: Verbal Rating Scale, AVF: Arteriovenous Fistula

Keywords: EMLA; Lidocaine; Local Anesthetic; Numeric Rating Scale; Phlebotomy; Pain; Venipuncture; Verbal Rating Scale

Citation: Angkejaya OW, Syahrony S, Yunita S, Ahmad NHDJF, Abdullah MR, Titaley C. Comparison of analgesic effects of alkalinized 2.46% lidocaine versus 5% EMLA cream applied topically before phlebotomy. Anaesth. pain intensive care 2025;29(4):277-280. DOI: 10.35975/apic.v29i4.2851

Received: May 09, 2024; Revised: October 26, 2024; Accepted: January 01, 2025