Topical skin anesthesia before inserting hemodialysis cannula

To the Editor.— A new topical anesthetic cream based on a eutectic mixture containing equiponderal amounts of lidocaine based and pnilocaine base has been developed recently.1 In a controlled study, Halpérin2 demonstrated convincingly that this ointment reduces substantially the pain caused by venous, subcutaneous drug reservoir, and lumbar punctures in children submitted to painful diagnostic and therapeutic procedures because of cancer. Pain inflicted by insertion of large cannulas into arteriovenous fistulas in children and adolescents on regular hemodialysis is cause of concern for children on regular hemodialysis.