{"id":{"repo_id":"aachen","oai_identifier":"oai:publications.rwth-aachen.de:56428"},"canonical_url":"https://search.dev.ndltd.org/etd/aachen/oai:publications.rwth-aachen.de:56428","repository":{"repo_id":"aachen","name":"RWTH Aachen University","base_url":"https://publications.rwth-aachen.de/oai2d"},"display":{"title":"Zweizeitige Anwendung von EMLA-Creme und GTN-Salbe zur schmerzlosen Venenpunktion bei Kindern","abstract":"Problem: The use of EMLA-cream for painless vein-puncture with children causes a local vasoconstriction, so a successful puncture can be impeded (1). The addition of Glyceroltrinitrat (GTN) (2) improves the vein-filling, but neutralizes the analgesic effect (3). This lead to the investigation, whether the analgesic effect is maintained when EMLA-cream and GTN-ointment are applied at an interval of time. Method: After the official approval by the ethics committee we investigated 101 patients (age 2-14). All children received 2,5 g EMLA-cream onto the back of one hand 90 min before the vain-puncture under occlusion-film. The cream was wiped off after 60 min and on the same spot 4 mg GTN (ointment of 0,5%) was applied with one group (E+N, n=54), whereas placebo-cream was applied with the other group (E+P, n=47) 30 min before the puncture. Immediately before the puncture the degree of sedation, the local skin-reaction, number and visibility of the veins on the back of the hand were assessed; after the puncture its difficulty and the child�s reaction as well as the necessity of a second puncture were registered. Statistical analysis and evaluation: exact Fischer-test. Analysis: Both groups were equally divided with regard to sex, age and degree of sedation. Children of the E+N-group showed a skin turned pale (3,8%), unchanged skin (5,8%) and a skin turned red (90,4%) under the spot of application; the corresponding results of the E+P-group were 85,1%, 2,1% and 12,8% (p<0,001). At least one vein of the back of the hand was visible with 94,1% of the patients of the E+N-group, but only with 10,8% of the E+P-group (p<0,001). In the E+N-group the veins could be punctered very easily with 82,7%, normally with 9,6% and with difficulty with 7,7%. In the E+P-group the order was reverse (4,3%, 8,7% and 87,0%, p<0,001). 86,8% of the children with EMLA+GTN showed no, 9,4% a weak and 3,8% a strong reaction to the pain stimulus; the corresponding results in the EMLA+placebo-group were 78,7%, 14,9% and 6,4% Conclusion: The application of EMLA and GTN at an interval of time leads to a significantly improved filling of the veins of the back of the hand and to a high rate of successful punctures by neutralizing the local vein-constriction without losing the analgesic effect of EMLA-cream.","abstract_html":"Problem: The use of EMLA-cream for painless vein-puncture with children causes a local vasoconstriction, so a successful puncture can be impeded (1). The addition of Glyceroltrinitrat (GTN) (2) improves the vein-filling, but neutralizes the analgesic effect (3). This lead to the investigation, whether the analgesic effect is maintained when EMLA-cream and GTN-ointment are applied at an interval of time. Method: After the official approval by the ethics committee we investigated 101 patients (age 2-14). All children received 2,5 g EMLA-cream onto the back of one hand 90 min before the vain-puncture under occlusion-film. The cream was wiped off after 60 min and on the same spot 4 mg GTN (ointment of 0,5%) was applied with one group (E+N, n=54), whereas placebo-cream was applied with the other group (E+P, n=47) 30 min before the puncture. Immediately before the puncture the degree of sedation, the local skin-reaction, number and visibility of the veins on the back of the hand were assessed; after the puncture its difficulty and the child�s reaction as well as the necessity of a second puncture were registered. Statistical analysis and evaluation: exact Fischer-test. Analysis: Both groups were equally divided with regard to sex, age and degree of sedation. Children of the E+N-group showed a skin turned pale (3,8%), unchanged skin (5,8%) and a skin turned red (90,4%) under the spot of application; the corresponding results of the E+P-group were 85,1%, 2,1% and 12,8% (p&lt;0,001). At least one vein of the back of the hand was visible with 94,1% of the patients of the E+N-group, but only with 10,8% of the E+P-group (p&lt;0,001). In the E+N-group the veins could be punctered very easily with 82,7%, normally with 9,6% and with difficulty with 7,7%. In the E+P-group the order was reverse (4,3%, 8,7% and 87,0%, p&lt;0,001). 86,8% of the children with EMLA+GTN showed no, 9,4% a weak and 3,8% a strong reaction to the pain stimulus; the corresponding results in the EMLA+placebo-group were 78,7%, 14,9% and 6,4% Conclusion: The application of EMLA and GTN at an interval of time leads to a significantly improved filling of the veins of the back of the hand and to a high rate of successful punctures by neutralizing the local vein-constriction without losing the analgesic effect of EMLA-cream.","abstract_has_math":false,"creators":["Ha-Phuoc, Hoang"],"institution":"Publikationsserver der RWTH Aachen University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Kalff, Günter"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2000,"date_issued":"2000","date_published":"2000","updated_at":"2026-07-30T19:41:53Z","subjects":["info:eu-repo/classification/ddc/610","Medizin"],"languages":["ger"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118533%22"],"render_values":[{"text":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118533%22","href":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118533%22","code":true}]}]},"links":{"outbound_url":"https://publications.rwth-aachen.de/record/56428","outbound_label":"Repository record","outbound_source":"dc:identifier"},"source_record":{"url":"https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A56428","prefix":"oai_dc"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Kalff, Günter"]},{"key":"dc:creator","label":"Author","values":["Ha-Phuoc, Hoang"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:coverage","label":"Dc Coverage","values":["DE"]},{"key":"dc:date","label":"Dc Date","values":["2000"]},{"key":"dc:publisher","label":"Institution","values":["Publikationsserver der RWTH Aachen University"]},{"key":"dc:relation","label":"Dc Relation","values":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-1222"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["info:eu-repo/classification/ddc/610","Medizin"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["ger"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/record/56428","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118533%22"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Problem: The use of EMLA-cream for painless vein-puncture with children causes a local vasoconstriction, so a successful puncture can be impeded (1). The addition of Glyceroltrinitrat (GTN) (2) improves the vein-filling, but neutralizes the analgesic effect (3). This lead to the investigation, whether the analgesic effect is maintained when EMLA-cream and GTN-ointment are applied at an interval of time. Method: After the official approval by the ethics committee we investigated 101 patients (age 2-14). All children received 2,5 g EMLA-cream onto the back of one hand 90 min before the vain-puncture under occlusion-film. The cream was wiped off after 60 min and on the same spot 4 mg GTN (ointment of 0,5%) was applied with one group (E+N, n=54), whereas placebo-cream was applied with the other group (E+P, n=47) 30 min before the puncture. Immediately before the puncture the degree of sedation, the local skin-reaction, number and visibility of the veins on the back of the hand were assessed; after the puncture its difficulty and the child�s reaction as well as the necessity of a second puncture were registered. Statistical analysis and evaluation: exact Fischer-test. Analysis: Both groups were equally divided with regard to sex, age and degree of sedation. Children of the E+N-group showed a skin turned pale (3,8%), unchanged skin (5,8%) and a skin turned red (90,4%) under the spot of application; the corresponding results of the E+P-group were 85,1%, 2,1% and 12,8% (p<0,001). At least one vein of the back of the hand was visible with 94,1% of the patients of the E+N-group, but only with 10,8% of the E+P-group (p<0,001). In the E+N-group the veins could be punctered very easily with 82,7%, normally with 9,6% and with difficulty with 7,7%. In the E+P-group the order was reverse (4,3%, 8,7% and 87,0%, p<0,001). 86,8% of the children with EMLA+GTN showed no, 9,4% a weak and 3,8% a strong reaction to the pain stimulus; the corresponding results in the EMLA+placebo-group were 78,7%, 14,9% and 6,4% Conclusion: The application of EMLA and GTN at an interval of time leads to a significantly improved filling of the veins of the back of the hand and to a high rate of successful punctures by neutralizing the local vein-constriction without losing the analgesic effect of EMLA-cream."]},{"key":"dc:source","label":"Dc Source","values":["Aachen : Publikationsserver der RWTH Aachen University 58 S. (2000). = Aachen, Techn. Hochsch., Diss., 2000"]},{"key":"dc:title","label":"Title","values":["Zweizeitige Anwendung von EMLA-Creme und GTN-Salbe zur schmerzlosen Venenpunktion bei Kindern"]}]}],"canonical_facts":{"dc:contributor":["Kalff, Günter"],"dc:coverage":["DE"],"dc:creator":["Ha-Phuoc, Hoang"],"dc:date":["2000"],"dc:description":["Problem: The use of EMLA-cream for painless vein-puncture with children causes a local vasoconstriction, so a successful puncture can be impeded (1). The addition of Glyceroltrinitrat (GTN) (2) improves the vein-filling, but neutralizes the analgesic effect (3). This lead to the investigation, whether the analgesic effect is maintained when EMLA-cream and GTN-ointment are applied at an interval of time. Method: After the official approval by the ethics committee we investigated 101 patients (age 2-14). All children received 2,5 g EMLA-cream onto the back of one hand 90 min before the vain-puncture under occlusion-film. The cream was wiped off after 60 min and on the same spot 4 mg GTN (ointment of 0,5%) was applied with one group (E+N, n=54), whereas placebo-cream was applied with the other group (E+P, n=47) 30 min before the puncture. Immediately before the puncture the degree of sedation, the local skin-reaction, number and visibility of the veins on the back of the hand were assessed; after the puncture its difficulty and the child�s reaction as well as the necessity of a second puncture were registered. Statistical analysis and evaluation: exact Fischer-test. Analysis: Both groups were equally divided with regard to sex, age and degree of sedation. Children of the E+N-group showed a skin turned pale (3,8%), unchanged skin (5,8%) and a skin turned red (90,4%) under the spot of application; the corresponding results of the E+P-group were 85,1%, 2,1% and 12,8% (p<0,001). At least one vein of the back of the hand was visible with 94,1% of the patients of the E+N-group, but only with 10,8% of the E+P-group (p<0,001). In the E+N-group the veins could be punctered very easily with 82,7%, normally with 9,6% and with difficulty with 7,7%. In the E+P-group the order was reverse (4,3%, 8,7% and 87,0%, p<0,001). 86,8% of the children with EMLA+GTN showed no, 9,4% a weak and 3,8% a strong reaction to the pain stimulus; the corresponding results in the EMLA+placebo-group were 78,7%, 14,9% and 6,4% Conclusion: The application of EMLA and GTN at an interval of time leads to a significantly improved filling of the veins of the back of the hand and to a high rate of successful punctures by neutralizing the local vein-constriction without losing the analgesic effect of EMLA-cream."],"dc:identifier":["https://publications.rwth-aachen.de/record/56428","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118533%22"],"dc:language":["ger"],"dc:publisher":["Publikationsserver der RWTH Aachen University"],"dc:relation":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-1222"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Aachen : Publikationsserver der RWTH Aachen University 58 S. (2000). = Aachen, Techn. Hochsch., Diss., 2000"],"dc:subject":["info:eu-repo/classification/ddc/610","Medizin"],"dc:title":["Zweizeitige Anwendung von EMLA-Creme und GTN-Salbe zur schmerzlosen Venenpunktion bei Kindern"],"dc:type":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]},"updated_at":"2026-07-30T19:41:53Z"}