Tetracaine-Lidocaine-Phenylephrine Topical Anesthesia Compared with Lidocaine Infiltration During Repair of Mucous Membrane Lacerations in Children

This study compared the effectiveness of a new topical anesthetic, tetracaine-lidocaine phenylephrine (TetraLidoPhen), with that of lidocaine infiltration during repair of mucous membrane lacerations in children. It was conducted in the emergency department of an urban children's hospital with...

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Bibliographic Details
Published in:Clinical pediatrics 1998-07, Vol.37 (7), p.405-412
Main Authors: Smith, Gary A., Cohen, Daniel M., Strausbaugh, Steven D., Shields, Brenda J., Harbeck-Weber, Cynthia, Powers, Jean D.
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia, Local
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Child, Preschool
Drug Evaluation
Facial Injuries - drug therapy
Female
Health care
Humans
Infant
Lidocaine - administration & dosage
Lidocaine - pharmacology
Local anesthesia. Pain (treatment)
Male
Medical sciences
Membranes
Mouth Mucosa - drug effects
Mouth Mucosa - injuries
Mucous Membrane - drug effects
Mucous Membrane - injuries
Pediatrics
Phenylephrine - administration & dosage
Phenylephrine - pharmacology
Tetracaine - administration & dosage
Tetracaine - pharmacology
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Summary:This study compared the effectiveness of a new topical anesthetic, tetracaine-lidocaine phenylephrine (TetraLidoPhen), with that of lidocaine infiltration during repair of mucous membrane lacerations in children. It was conducted in the emergency department of an urban children's hospital with use of a prospective, randomized, blinded study design. Participants were 90 children 1 year of age or older with a laceration 5 cm or less in length on or near a mucous membrane that required suturing. They were randomly assigned to one of two treatment groups, with 45 patients in each group. Pain felt during suturing was scored by suture technicians, research assistants, a videotape reviewer, parents, and patients 5 years of age and older using a Visual Analogue Scale (VAS). Suture technicians, research assistants, a videotape reviewer, and parents also scored pain using a seven-point Likert scale. In addition, suture technicians completed an Anesthesia Effectiveness scale and a Wound Blanching scale. The laceration was located near the eyes in 71 patients (79%), and on or near the lips in 19 (21%). Lidocaine infiltration performed significantly better than topical TetraLidoPhen in comparisons of Likert scores of suture technicians (P=0.007), research assistants (P=0.005), the videotape reviewer (P=0.003), and parents (P=0.03); Anesthetic Effectiveness scale scores of suture technicians (P=0.00002; relative risk (RR)=1.83, 95% confidence interval 1.36
ISSN:0009-9228
1938-2707
DOI:10.1177/000992289803700702