Comparison of Topical Anesthetics with Lidocaine Infiltration During Laceration Repair in Children

This study is a randomized, blinded trial that compares the effectiveness of a new topical anesthetic preparation of 2% mepivacaine and 1:100,000 norepinephrine (Mepivanor); a topical solution of 1% tetracaine, 1:4,000 adrenaline, and 4% cocaine (TAC); and 1 % lidocaine infiltration during laceratio...

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Bibliographic Details
Published in:Clinical pediatrics 1997-01, Vol.36 (1), p.17-23
Main Authors: Smith, Gary A., Strausbaugh, Steven D., Harbeck-Weber, Cynthia, Shields, Brenda J., Powers, Jean D.
Format: Article
Language:English
Subjects:
Adolescent
Analysis of Variance
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthetics, Combined
Anesthetics, Local
Biological and medical sciences
Chi-Square Distribution
Child
Child, Preschool
Cocaine
Double-Blind Method
Epinephrine
Female
Follow-Up Studies
Humans
Lidocaine
Local anesthesia. Pain (treatment)
Male
Medical sciences
Mepivacaine
Pain Measurement
Suture Techniques
Tetracaine
Treatment Outcome
Wounds, Penetrating - surgery
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Summary:This study is a randomized, blinded trial that compares the effectiveness of a new topical anesthetic preparation of 2% mepivacaine and 1:100,000 norepinephrine (Mepivanor); a topical solution of 1% tetracaine, 1:4,000 adrenaline, and 4% cocaine (TAC); and 1 % lidocaine infiltration during laceration repair in children. The study was conducted in the emergency department of a large academic children's hospital. Study participants were children 2 years of age or older with a laceration on the face or scalp, 5 cm or less in length, that required suturing. Patients were randomly assigned to receive Mepivanor topical solution, TAC topical solution, or lidocaine infiltration anesthesia prior to laceration repair. Seventy-one patients were enrolled in the study during a 2-month period. Outcome measures assessed pain perceptions using a Visual Analogue Scale (VAS) and a seven-point Likert scale. There was statistical power to detect differences of 1.2 to 1.7 units for the VAS outcome measures using alpha = 0.05 and beta = 0.20. There were no statistically significant (P >0.05) differences between TAC and 1% lidocaine infiltration in providing effective anesthesia. Mepivanor was generally less effective in providing adequate anesthesia during laceration repair than TAC and lidocaine infiltration, with Tukey's post hoc test for ANOVA demonstrating statistically significant (P
ISSN:0009-9228
1938-2707
DOI:10.1177/000992289703600103