MedPath

Needle Procedures Success Rate After Application of Ralydan vs EMLA in Children

Phase 3
Completed
Conditions
Procedural Pain Relief
Interventions
Drug: Lidocaine/Tetracaine patch
Registration Number
NCT02519660
Lead Sponsor
IRCCS Burlo Garofolo
Brief Summary

Needle-related procedures are among the most common sources of pain and distress for children in the health care setting. More than 50% of children reported pain during these procedures. The necessity for pain management during these procedures is well established. Topical anesthesia has been shown to be effective in managing needle-related pain. Eutectic mixture of local anaesthetic (EMLA) cream is the topical anesthetic most used. The application of this mixture of lidocaine and prilocaine reduce pain during needle procedures in children. To be effective EMLA cream must be applied for at least 60 minutes before needle procedure. This is the major limitation for its use in emergency settings.

Ralydan patch is a drug delivery system designed to release local anaesthetics (lidocaine and tetracaine) through the skin. There is evidence of pain relief after 30 minutes from its application. Only one randomized controlled trial compared the two topical anaesthetics in children during venipuncture and showed that Ralydan patch led to superior analgesia than EMLA cream, even if in this study the two anaesthetics were applied only for 35 minutes before needle procedure. No differences were found in success rate of the procedure and vein visibility. In adult patients, Ralydan and EMLA were equally effective in pain relief after 60 minutes from application.

To the best of the investigators' knowledge there is no published study that compared needle procedure success rate in children and pain relief effectiveness of lidocaine/tetracaine patch and lidocaine/prilocaine cream, at time of their maximum analgesic effect.

The aim of this study is to compare Ralydan patch and EMLA cream at time of their maximum analgesic effect (30 minutes vs 60 minutes), regard to needle procedure success rate at the first attempt and pain relief in children.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
339
Inclusion Criteria
  • Age 3 to 10 years
  • Need for peripheral IV line or venipuncture
  • Informed consent signed by parents or legal guardians
Exclusion Criteria
  • Need for emergency care
  • Known allergy or sensitivity to local anesthetics

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Lidocaine/Prilocaine cream (EMLA)Lidocaine/Prilocaine creamEMLA cream is an eutectic mixture of local anaesthetic (lidocaine, prilocaine). It is applied in the site of venipuncture 60 minutes before needle procedure
Lidocaine/Tetracaine patch (Ralydan)Lidocaine/Tetracaine patchRalydan patch is a drug delivery system designed to release local anaesthetics (lidocaine and tetracaine) through the skin. It is applied in the site of venipuncture 30 minutes before needle procedure
Primary Outcome Measures
NameTimeMethod
Success at the first attemptIntraoperative

Percentage of success at first attempt

Secondary Outcome Measures
NameTimeMethod
Pain scoreIntraoperative

The pain during the procedure will be evaluate using pain rating scale appropriate for age

Adverse eventsUp to 15 minutes after the procedure

The number and the type of adverse events will be recorded

Trial Locations

Locations (3)

IRCCS Burlo Garofolo

🇮🇹

Trieste, Friuli Venezia Giulia, Italy

Ospedale Pediatrico Pausilipon - Servizio di terapia del dolore e cure palliative

🇮🇹

Napoli, Campania, Italy

Università degli studi di Padova - Centro Regionale Veneto di terapia del dolore e cure palliative pediatriche

🇮🇹

Padova, Veneto, Italy

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