Comparison of EMLA Cream versus Lidocaine Injection for Lumbar Puncture Pain Control in Pediatric Oncology Patients.

Background  Subcutaneous lidocaine injection and topical EMLA cream are both used to control lumbar puncture (LP) pain; however, local analgesia usage is not standardized. Methods  We conducted a prospective, single-blinded, randomized-controlled crossover trial comparing the two modalities in reducing LP pain. Pediatric patients requiring serial LPs were randomly assigned to receive EMLA cream or lidocaine injection prior to LP. On the subsequent LP, analgesia was defaulted to the other agent. Pain was assessed using the Wong-Baker FACES Pain Rating Scale pre-procedure: 30 to 60 minutes post-LP, and 24 hours post-procedure. Results  Ten patients were included in the analysis (median age: 5.5 years). Pain ratings at 1 and 24 hours post-LP did not differ between the two strategies ( p  = 0.79). No adverse local reactions were reported for either agent. Conclusion  Accordingly, both lidocaine and EMLA cream provided effective LP pain control.