Uptake of immunisation against hepatitis B among surgeons in Wessex Regional Health Authority.

We found a small but significant increase in methaemoglobin concentration in 1-6 year old children after routine administration of 5 g of prilocainelignocaine cream before surgery. Although the peak methaemoglobin concentration observed was well within safe limits, the finding of an increased concentration 24 hours after administration suggests that cumulative effects may occur in children receiving the cream daily. Some of these may be at special risk owing to pre-existing anaemia, coadministration of sulphonamide antibiotics, or reduced renal excretion of metabolites of prilocaine. The minimum effective dose should be used in all children requiring daily applications of prilocaine-lignocaine cream.