The effect of topical etofenamate with nicotinate on the success of peripheric venous cannulation

Objective: Venipuncture is a commonly performed procedure in hospitalized patients. In this study we aimed to investigate the effects of etofenamate with nicotinate (Thermo-Rheumon® Cream) on the effectiveness on venous cannulation success and procedural pain in pediatric patients. Patients and Methods: Sixty children, aged 7-12 yr, ASA physical status I-II, undergoing elective adenoidectomy and/or tonsillectomy surgery were allocated into two groups. In group etofenamate (n=30), topical agent was applicated on dorsum of the non dominant hand before venipuneture then covered with a transparent dressing for 10 min. In EMLA (cutectic mixture of local anesthetics) group (n=30), cream was applicated 1 hour before the procedure then covered with a transparent dressing. In both groups, venous cannulation was performed with 22 G cannula. Difficulty in cannulation was evaluated by a 4 point scale and procedural pain by facial pain scale (range 0-10) and behavioral response scale (range 0-3) were scored. Results: Significant venipuncture success at the first attempt was observed in group etofenamate compared with EMLA group (p<0.05). The incidences of pruritus, erythema and discomfort were higher in etofenamate group (p<0.05). Both facial and behavioral pain scores were found lower in EMLA group (p<0.05). Conclusion: We concluded that etofenamate with nicotinate may provide significant benefit in augmenting the venipuneture success during intravenous cannula insertion in pediatric population but the effect on procedural pain is limited.