Topical Anesthetics Comparison

Topical Anesthetics
Numbing Creams
When time permits, needle pain can be greatly reduced using topical pain relief - pharmaceuticals, specifically topical anesthetic numbing creams and gels -- which numb the skin in 20 – 60 minutes. This topical pain relief option has also been tested for Botox injection pain, tattoo removal, and laser hair removal pain to name a few. One over-the-counter and several prescription pain control creams are available in the United States. Cold Spray is included in this list as well since some doctors' offices offer this option.

Buzzy® has been studied as an alternative or addition to medical pain relief using topical anesthetics. One study found equivalent pain relief for children when comparing Buzzy, LMX4, and the combination.  In the subset of Caucasian children, the Buzzy + LMX combination was significantly better than either alone (Mundy K et al).  Pain relief are listed in order attempting to  balance cost, time, effectiveness, and ease of use for IV sticks. Side effects or individual preference may change the order for you.
Download a synopsis here for easy reference.   topical_anesthesia_tips.pdftopical_anesthesia_tips.pdf

Topical Pain Relief Options:
Buzzy®:
Type - Device
Over the counter - Yes
Price per use – $0.09/use home model up to $2.29/use if single patient ice packs are used with healthcare model
Minimum Time to be effective - 30 seconds
Bonus info!- Improves IV starts, proven to decrease anxiety

Eloquest's Anesthetic Cream LMX4:
Type - Cream
Over the counter - Yes
Price per use - $6/site Hospital cost, $26/15 grams Amazon.com (about 3 sites)
Minimum Time to be effective - 20 minutes
Bonus info!- Wears off quickly, reduce painful removal of tegaderm with Glad Press-N-Seal

EMLA:
Type - Cream
Over the counter - No
Price per use - $8 - $12 hospital cost/site
Minimum Time to be effective - 60 min, will vasoconstrict until 2 hours then vasodilate
Bonus info!- Deepest penetration, can be left on up to 4 hours

Synera:
Type - Patch
Over the counter - No
Price per use - $20
Minimum Time to be effective - 20 min
Bonus info!- Heat release mechanism, toxic if chewed, stiff so may need tape for smaller body parts

Pain-Ease:
Type - Cold Spray
Over the counter - No
Price per use - $1
Minimum Time to be effective - 30 seconds
Bonus info!- Cold may hurt younger than 6 years, works well age 12+
Ametop:
Type - Gel
Over the counter - Yes, outside US
Price per use - N/A in USA
Minimum Time to be effective - 30 min
Bonus info!- Lasts 4-6 hours

Myolaxin:
Type - Ointment
Over the counter - Made and available In India
Price per use - <$2
Minimum Time to be effective - 60 min
Bonus info!- Capsaicin ointment 15%, Hot pepper pain relief


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