Evaluation of EMLA cream for relieving pain during needle insertion on totally implantable venous access device

Purpose: Needle insertion is a routine procedure performed on cancer patients with totally implantable venous access device. Although this procedure is painful for most of the patients, it is regularly performed without topical application of local anesthetics. In our study, we assess the degree of pain associated with different duration times of EMLA cream. Methods: A total of 361 cancer patients with totally implantable venous access devices were randomly divided into three groups: group 1-placebo, group 2-30 min after application of EMLA, and group 3-60 min after application of EMLA. In this double-blinded prospective study, the efficacy of EMLA cream was compared with a placebo cream by comparing the degree of pain experienced by the patient who was evaluated during and after needle insertion on a numeric rating scale. Results: The mean +/- standard deviation of pain experienced by the patients was significantly (p < 0.05) lower in group C (0.69 +/- 0.98) than groups B (1.11 +/- 1.14) and A (1.91 +/- 1.40). No significant (p > 0.05) difference was found in mean scores from inexperienced and experienced procedures of needle insertions among three groups. Comparing male patients, the female patients in group 1 and group 2 had lower numeric rating scale (1.59 +/- 0.94, 1.39 +/- 1.35; p < 0.01). Conclusion: The present results review that the application of EMLA cream for 30 min is suitable, acceptable, and convenient in cancer patients with totally implantable venous access device undergoing needle insertion.