Rogers TL, Ostrow CL. The use of EMLA cream to decrease venipuncture pain in children. J Pediatr Nurs. 2004;19(1):33-39.

Initiating venipuncture therapy is a painful procedure for children. Along with the pain of the needle itself is the inability of children to understand the reason for starting the intravenous line or drawing blood. There is also anxiety in children regarding having to hold still for the procedures. For this reason, EMLA cream has been used over the past 20 years to reduce the pain of the procedures. However, there has not been any effort to quantify the results of this medication.

This meta-analysis reviewed the findings of 10 studies where EMLA cream was administered to children at least 60 minutes prior to a venipuncture or blood draw. In each of these studies, it was found that EMLA was as effective as other analgesic measures such as applying Ametop cream or iontophoresis in reducing pain. The limitations of the findings included the necessary 60-minute wait between administration of the cream and the venipuncture, the inability to differentiate venipunctures that were difficult to initiate or required multiple needle insertions, and the cost-effectiveness of the cream.

The researchers reported that the overall findings were positive toward the use of EMLA cream. Future research was recommended to look into the safety issues relating to the cream, whether or not EMLA could be used for immunizations, and case-control studies regarding whether the 60-minute wait prior to venipuncture is necessary or could be shortened without reducing the effectiveness of the pain reduction.