A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply:
a. 4% Liposomal Lidocaine (LMX) 15 minutes before the procedure.
b. A transdermal fentanyl (Duragesic) patch immediately before the procedure.
c. Eutectic mixture of local anesthetics (EMLA) 1 hour before the procedure.
d. EMLA 30 minutes before the procedure.
ANS: C
EMLA is an effective analgesic agent when applied to the skin 60 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. LMX must be applied 30 minutes before the procedure. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain control. For maximal effectiveness, EMLA must be applied approximately 60 minutes in advance.
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