This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Smith, G. A.
Right arrow Articles by Powers, J. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Smith, G. A.
Right arrow Articles by Powers, J. D.
Related Collections
Right arrow Emergency Medicine
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 100 No. 5 November 1997, pp. 825-830

New Non-Cocaine-Containing Topical Anesthetics Compared With Tetracaine-Adrenaline-Cocaine During Repair of Lacerations

Received Dec 17, 1996; accepted Mar 27, 1997.

Gary A. Smith*, Steven D. StrausbaughDagger , Cynthia Harbeck-Weber§, Daniel M. Cohen*, Brenda J. Shields*, and Jean D. Powersparallel

From the * Division of Emergency Medicine, * § Department of Pediatrics, * Dagger  The Ohio State University College of Medicine, * § parallel  Children's Hospital, Columbus, Ohio.

Objective.  To compare the effectiveness of three new topical anesthetics that do not contain cocaine (prilocaine-phenylephrine, tetracaine-phenylephrine [tetraphen], and tetracaine-lidocaine-phenylephrine) to that of tetracaine-adrenaline-cocaine (TAC) during laceration repair in children.

Design.  Prospective, randomized, double-blind clinical trial.

Setting.  The emergency department of an urban children's hospital.

Participants.  Children 1 year of age or older with a laceration <=  5 cm in length that required suturing.

Intervention.  A total of 240 children were randomly assigned to one of four treatment groups.

Outcome Measures.  Pain felt during suturing was scored by suture technicians, research assistants, parents, and patients >= 5 years of age using a visual analogue scale (VAS). Suture technicians, research assistants, and parents also scored pain using a seven-point Likert scale. In addition, suture technicians completed an anesthetic effectiveness scale.

Results.  There was consistently no difference demonstrated between the effectiveness of tetraphen and that of TAC for each outcome measure of each observer group. A statistically significant difference was seen among anesthetics when comparing VAS and Likert scale scores of suture technicians and Likert scale scores of research assistants. Based on post hoc analyses, these statistically significant differences were between TAC and prilocaine-phenylephrine (suture technician VAS and Likert scale) and between TAC and tetracaine-lidocaine-phenyl-ephrine (suture technician Likert scale), but not between TAC and tetraphen. When power analyses were performed using alpha  = 0.05 and beta  = 0.20, it was possible to detect a difference of 1.2 VAS units for each of the observer groups. Based on anesthetic effectiveness scale scores, the three new topical preparations collectively performed significantly better on the face and scalp than on the extremities (relative risk = 1.83; 95% confidence interval 1.20 < relative risk < 2.79).

Conclusion.  This study demonstrated the effectiveness and safety of three new non-cocaine-containing topical anesthetics. Consistently, there was no statistical difference demonstrated between the effectiveness of tetraphen and that of TAC for each outcome measure of each observer group. Tetraphen offers an effective alternative to TAC during laceration repair in children.

Key words: prilocaine, tetracaine, lidocaine, TAC, topical anesthesia, laceration, pediatric emergency department.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Scand J Public HealthHome page
C. Andersson, K. O. Johnsson, M. Berglund, and A. Ojehagen
Measurement properties of the Arnetz and Hasson stress questionnaire in Swedish university freshmen
Scand J Public Health, May 1, 2009; 37(3): 273 - 279.
[Abstract] [PDF]

Home page
 CLIN PEDIATRHome page
B. J. Shields, D. M. Cohen, C. Harbeck-Weber, J. D. Powers, and G. A. Smith
Pediatric Pain Measurement Using a Visual Analogue Scale: A Comparison of Two Teaching Methods
Clinical Pediatrics, April 1, 2003; 42(3): 227 - 234.
[Abstract] [PDF]

Home page
 NEJMHome page
C. B. Berde and N. F. Sethna
Analgesics for the Treatment of Pain in Children
N. Engl. J. Med., October 3, 2002; 347(14): 1094 - 1103.
[Full Text] [PDF]

Home page
 Emerg. Med. J.Home page
S Bush
Is cocaine needed in topical anaesthesia?
Emerg. Med. J., September 1, 2002; 19(5): 418 - 422.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
B. Krauss and S. M. Green
Sedation and Analgesia for Procedures in Children
N. Engl. J. Med., March 30, 2000; 342(13): 938 - 945.
[Full Text] [PDF]

Home page
 JWatch Emergency Med.Home page
Cocaine-Free Anesthetics for Pediatric Suturing
Journal Watch Emergency Medicine, January 1, 1998; 1998(101): 14 - 14.
[Full Text]