Background: EMLA® cream allows effective analgesia for painful procedures but has a risk of prilocaine-induced methæmoglobin formation(MetHb-F). MetHb-reductase activity is low in neonate (NN) but all cases of MetHb-F reported have been associated to a prolonged time of application or to concomittent administration of other MetHb-inducing agents.

Intervention: Application of 0,5 to 1 ml of EMLA®. Occlusive dressing during 30 to 40 mn (maximum). Effective analgesia if no arm withdrawal at the needle insertion. MetHb mesured by spectrophotometry 8 hours after EMLA® application.

Subjects: 48 preterm NN included. Mean weight 993±315 g. Mean gestationnel age 29±2, 5 weeks. Postnatal age 5, 5±2, 5 days.

Results: Mean MetHb at 8 hours 0, 68±0, 55% (range: 0, 1%-2, 8%). No local side effect. Effective analgesia in 45 NN.

Conclusion: EMLA® application is effective in NN. No case of increased MetHb value observed even in extremely low birthweight infants with very strict precautions of use: occlusion time less than 40 mn; limited area of application.