Eutectic mixture of local anesthetics’ dosage in newborns
a scoping review
Keywords:newborn, pain, local anesthetics, EMLA Cream
Introduction: Although Eutectic Mixture of Local Anesthetics (EMLA) is an easily available solution, it is not yet widely used in neonatal care due to the lack of evidence of an effective administration dosage.
Objectives: Identify how EMLA cream is used to reduce pain, without adverse reaction, in newborn infants undergoing painful medical procedures.
Methods: A scoping review was conducted to map literature concerning a population, concept, context (PCC) question, considering literature from electronic databases and gray literature, published between 2002 and 2021, with full-text available and with no language restrictions.
Results: Twelve documents concerning a 2661 newborn population – from 28 weeks gestational age until full-term newborns – considering EMLA cream efficacy and describing EMLA cream’s amount and skin contact time. Eight protocols recommend the use of an occlusive dressing. One paper identified pallor and erythema reactions.
Conclusion: EMLA is effective when used in newborns undergoing painful procedures. Although there is no consensus on EMLA cream’s dosage, the most frequent amount used is 0,5g in pre-term newborns and 1g in full-term newborns. The most common time of skin contact is 60 minutes. Although this is the most frequent dosage, the amount ranges from 0,5 up to 2g, and the time of skin contact ranges from 3 to 180 minutes. Most of the protocols have included occlusive dressing use.
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