[Use of EMLA cream in premature and full-term newborn infants. Study of efficacy and tolerance]

Arch Pediatr. 1995 Nov;2(11):1041-6. doi: 10.1016/0929-693x(96)81278-4.
[Article in French]


Background: Mild methemoglobinemia is a known side-effect of one of the constituents of EMLA cream, this topical local anesthetic is used with great caution in neonates.

Population and methods: One hundred and sixteen neonates admitted from January to July 1994 in an intensive care unit were included in the study. All required skin punctures which were performed 1 h 30-2 hours after EMLA had been applied on the skin. A reaction score (0 to 5) to skin puncture was established 157 times (120 after and 37 without local anesthesia); methemoglobin (Met Hb) concentrations were measured in 47 blood samples, 18-24 hours (40.4% of samples) or 2-3 days (36.2%) after application of EMLA.

Results: Ninety-four neonates were quiet before puncture (score 0-1). Among them, 57% of those who were given EMLA had a low score (2 or less) vs 18% without EMLA. A low reaction was observed in 65% when the dressings had been kept in place for at least 90 minutes vs 15% with a shorter application. A lower reaction was noted in 78.8% of cases after venopuncture (41% after arterial puncture). No Met Hb level was above 5% and 7 (15%), in five neonates, were between 3 and 5%. There was no clear relationship between methemoglobinemia and gestational age or duration of dressing.

Conclusion: EMLA cream is effective and safe in neonates including preterms, when it is applied in a small amount once a day.

MeSH terms

  • Administration, Cutaneous
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / adverse effects
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Drug Tolerance
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Lidocaine / administration & dosage*
  • Lidocaine / adverse effects
  • Lidocaine, Prilocaine Drug Combination
  • Methemoglobinemia / chemically induced*
  • Ointments
  • Prilocaine / administration & dosage*
  • Prilocaine / adverse effects


  • Anesthetics, Local
  • Drug Combinations
  • Lidocaine, Prilocaine Drug Combination
  • Ointments
  • Prilocaine
  • Lidocaine