We have evaluated the efficacy and safety of a preparation of 4% amethocaine gel in alleviating the pain of venous cannulation in children. In an initial open study of 148 children, clinically acceptable anaesthesia was achieved in 92% of cases. The preparation was then compared with 5% EMLA cream in a single-blind study in 94 patients using an application time of 40 min. We found clinically acceptable conditions in 85% of patients receiving amethocaine gel compared with 66% in the EMLA group. There were no significant adverse effects noted in each group, although 37% of those children treated with amethocaine gel showed localized erythema at the application site. The results suggest that amethocaine gel has greater efficacy and a faster onset time than EMLA cream when used for this purpose in children.