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Piroxicam gel, compared to EMLA cream is associated with less pain after venous cannulation in volunteers

[Un gel de piroxicam, comparé à une crème EMLA, est associé à moins de douleur après une canulation veineuse chez des volontaires]

From the Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Address correspondence to: Dr. G.D. Puri, Department of Anaesthesia and Intensive Care, PGIMER, Chandigarh-160012, India. Phone: 91-172-549717; Fax: 91-172-744401; E-mail: gdpuri007{at}hotmail.com

Purpose: To evaluate and compare the analgesic efficacy and anti-inflammatory effects of topical piroxicam gel vs eutectic mixture of local anesthetic (EMLA) cream applied to the peripheral venous cannulation site in adult volunteers.

Methods: Piroxicam gel and EMLA cream were randomly applied on the dorsum of the right and left hand of ten volunteers who acted as their own control. A venous cannula was inserted (no iv infusion) and removed after one hour. Pain scores and signs of inflammation were noted at the cannulation site up to 48 hr.

Results: Pain scores with piroxicam gel were higher on cannulation and on advancement of the cannula (P < 0.05). Thereafter, pain scores were significantly higher with EMLA (P < 0.05). Blanching was present at all the peripheral venous sites treated with EMLA cream. Signs of inflammation (erythema, edema) were not more frequent with EMLA than with piroxicam (P > 0.05). Induration was more frequent with EMLA at six hours.

Conclusion: In volunteers EMLA cream is associated with less pain on cannulation and cannula advancement compared to piroxicam gel. Topical application of piroxicam gel before peripheral venous cannulation alleviates pain and, possibly, inflammation in the period subsequent to cannulation itself.

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