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PEDIATRICS Vol. 113 No. 2 February 2004, pp. 410-411

EXPERIENCE AND REASON

EMLA Toxicity After Application for Allergy Skin Testing

James F. Parker, MD*, Atul Vats, MD{ddagger} and Greg Bauer, PharmD§

* Divisions of Pediatric Emergency Medicine
{ddagger} Pediatric Critical Care, Emory University School of Medicine, Children’s Healthcare of Atlanta at Egleston, Atlanta, Georgia
§ Georgia Poison Center, Grady Health System, Atlanta, Georgia

The first 20% of the full text of this article appears below.

EMLA (eutectic mixture of local anesthetics) is a eutectic mixture of lidocaine and prilocaine used to provide topical anesthesia for various procedures. When used properly, EMLA can provide anesthesia to a depth of 5 mm in intact skin, allowing for better pain control during superficial procedures (eg, venipuncture and lumbar puncture).1 Its use has grown widely over the past few years.

The adverse effects most commonly related to the use of EMLA are mild local reactions such as edema, erythema, and transient pallor. More-severe reactions, however, have been reported, including methemoglobinemia and seizures.1–6 Only 2 prior reports have described the association between the use of EMLA and the development of seizures.2 This case stands out from prior reports in that a proper amount of EMLA was used but applied to a large area of diseased skin.


   CASE REPORT
 
A healthy 3-year-old white female with a history of eczema was referred to an allergist because of seasonal and environmental allergy symptoms. She was scheduled for allergy skin testing. Her parents were given a prescription for a 5-g tube of EMLA to be applied to the patient’s back, which then was to be covered with plastic wrap, before arriving at the allergist’s office on the day of skin testing.

On the morning of the scheduled visit, the parents applied . . . [Full Text of this Article]

Address correspondence to James F. Parker, MD, Children’s Healthcare of Atlanta, 1645 Tullie Cir, Atlanta, GA 30329. E-mail: jparke4@emory.edu




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EMLA Toxicity in a 3-Year-Old Child
Journal Watch Dermatology, March 31, 2004; 2004(331): 5 - 5.
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