The anesthetic effectiveness of lidocaine-adrenaline-tetracaine gel on finger lacerations. Pediatr Emerg Care 2004 Dec;20(12):812-5
Date
12/02/2004Pubmed ID
15572968DOI
10.1097/01.pec.0000148029.61222.9fScopus ID
2-s2.0-11144336625 (requires institutional sign-in at Scopus site) 31 CitationsAbstract
OBJECTIVES: To determine the effectiveness of lidocaine-adrenaline-tetracaine (LAT) in providing adequate anesthesia for the repair of finger lacerations and to monitor the risk of digital ischemia following application of LAT gel to finger lacerations.
METHODS: A prospective case series. Children aged 5 to 18 years with a simple finger laceration-requiring repair were eligible for enrollment. The primary outcome measure was LAT success/failure. Failure was defined as any sharp sensation reported by the patient either before or during suturing. Enrolled patients had LAT gel applied to their laceration for 45 minutes, followed by an examination for signs of digital ischemia and standard laceration repair. Infiltration anesthesia (local subcutaneous injection/digital block) was provided for all LAT failures. Patients were followed up by phone within 3 to 5 days from discharge.
RESULTS: Sixty-seven patients were analyzed in the study. The mean age was 11.9 years. Forty-four (65.7%) of 67 patients were male and 46 (68.7%) were white. Locations of the lacerations were equally distributed on the dorsal and ventral surfaces. The overall LAT success rate was 53.7% (95% confidence interval [CI], 41.1% to 66.0%; 36/67). The success rate for dorsal surface lacerations was 68.6% (95% CI, 50.7% to 83.1%; 24/35) versus 37.5% (95% CI, 21.1% to 56.3%; 12/32) for ventral surface lacerations. The difference in success rates between dorsal and ventral surface lacerations was significant (Delta 31.1% [95% CI, 8.3% to 53.8%]). There were no differences in success rates for age, sex, or race. No signs of digital ischemia were noted in any of the 67 cases (0% [95% CI, 0.0% to 5.4%]).
CONCLUSIONS: LAT gel appears to be a safe and effective means of providing anesthesia for the repair of simple finger lacerations in children. It was most effective on the dorsal surface of the finger.
Author List
White NJ, Kim MK, Brousseau DC, Bergholte J, Hennes HMESH terms used to index this publication - Major topics in bold
Anesthesia, LocalAnesthetics, Local
Child
Drug Therapy, Combination
Epinephrine
Female
Finger Injuries
Gels
Humans
Lacerations
Lidocaine
Male
Pain
Prospective Studies
Tetracaine
