Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 7-Day Trial for You or Your Team.

Learn More →

Penile Absorption of EMLA Cream in Piglets: Implications for Use of EMLA in Neonatal Circumcision

Penile Absorption of EMLA Cream in Piglets: Implications for Use of EMLA in Neonatal Circumcision EMLA® (eutectic mixture of lidocaine and prilocaine) cream is currently not recommended for use in infants < 1 month of age because of the potential risk of methemoglobinemia as a result of the o-toluidine metabolite of prilocaine. We studied bioavailability and changes in methemoglobin levels following topical penile exposure to 1 g of EMLA cream for 1 hour in piglets. Lidocaine, prilocaine, and o-toluidine concentrations were measured simultaneously using a high-performance liquid chromatography method. The systemic bioavailability of EMLA was low: 4.0 ± (SD) 4.7% for lidocaine (range 0-13.6; n = 8) and 7.2 ± 5.7% for prilocaine (range 0-14.5; n = 8). The ratio between exposure to o-toluidine with EMLA versus intravenous administration (i.e., AUCemla/AUQv; see text) was also low: 4.2 ± 9.3% (range 0–28.6; n = 9). The mean maximum methemoglobin value after intravenous administration was 1.23 ± 0.64% (range 0.5–3.0; n = 12) and after penile application 0.99 ± 0.36% (range 0.5–2.0; n = 12). The methemoglobin value was elevated significantly above baseline after intravenous administration (p = 0.03), but not after penile application of EMLA. These findings suggest that penile administration of 1 g of EMLA may be safe for neonatal circumcision, but further study is required. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neonatology Karger

Penile Absorption of EMLA Cream in Piglets: Implications for Use of EMLA in Neonatal Circumcision

Download PDF
8 pages

Loading next page...
 
/lp/karger/penile-absorption-of-emla-cream-in-piglets-implications-for-use-of-fnjgj0oC5g

References

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
Karger
Copyright
© 1995 S. Karger AG, Basel
ISSN
1661-7800
eISSN
1661-7819
DOI
10.1159/000244254
Publisher site
See Article on Publisher Site

Abstract

EMLA® (eutectic mixture of lidocaine and prilocaine) cream is currently not recommended for use in infants < 1 month of age because of the potential risk of methemoglobinemia as a result of the o-toluidine metabolite of prilocaine. We studied bioavailability and changes in methemoglobin levels following topical penile exposure to 1 g of EMLA cream for 1 hour in piglets. Lidocaine, prilocaine, and o-toluidine concentrations were measured simultaneously using a high-performance liquid chromatography method. The systemic bioavailability of EMLA was low: 4.0 ± (SD) 4.7% for lidocaine (range 0-13.6; n = 8) and 7.2 ± 5.7% for prilocaine (range 0-14.5; n = 8). The ratio between exposure to o-toluidine with EMLA versus intravenous administration (i.e., AUCemla/AUQv; see text) was also low: 4.2 ± 9.3% (range 0–28.6; n = 9). The mean maximum methemoglobin value after intravenous administration was 1.23 ± 0.64% (range 0.5–3.0; n = 12) and after penile application 0.99 ± 0.36% (range 0.5–2.0; n = 12). The methemoglobin value was elevated significantly above baseline after intravenous administration (p = 0.03), but not after penile application of EMLA. These findings suggest that penile administration of 1 g of EMLA may be safe for neonatal circumcision, but further study is required.

Journal

Neonatology – Karger

Published: Jan 1, 1995

Keywords: Pharmacokinetics, lidocaine/prilocaine; Eutectic mixture, lidocaine/prilocaine; Local anesthesia, newborn animals; Methemoglobin concentration; Neonatal diseases; Penile circumcision, anesthetics

There are no references for this article.