Faculty Collaboration Database

Use of topical lidocaine in pediatric laceration repair: a review of topical anesthetics. Pediatr Emerg Care 1998 Dec;14(6):419-23

Date

01/09/1999

Pubmed ID

9881990

DOI

10.1097/00006565-199812000-00012

Scopus ID

2-s2.0-0032430736 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

OBJECTIVE: To determine whether application of topical aqueous lidocaine to a laceration attenuates the pain from the subsequent lidocaine injection in children.

DESIGN: Prospective, double-blind study.

SETTING: A large, urban, tertiary care children's hospital emergency department.

PATIENTS: A convenience sample of 100 children, five to 16 years of age, presenting with simple lacerations over a six-month period.

INTERVENTIONS: An unlabelled 3-ml solution of either 1% lidocaine or placebo (saline) was used to soak a Telfa pad (Kendall, Mansfield, MA) and then placed onto the laceration for 10 minutes. The wound was then injected with 1% lidocaine, irrigated, and sutured per standard emergency department protocol. Independent pain response was elicited from the patient and parent four times: before any intervention, after the soak, after the injection, and at the end of the procedure. Blood pressure and heart rates were recorded at the same intervals.

RESULTS: Four patients were excluded. Of the 96 remaining patients, 46 received the placebo and 50 received lidocaine. Age, sex, race, and laceration length and location were similar between groups. Physiologic parameters did not differ between groups. For all four pain ratings, the independent variables of age, sex, race, and laceration length or location did not differ between groups. Topical lidocaine was ineffective in relieving pain from the injection. When groups were combined, a significant negative correlation was noted for age versus injection pain (P = .035), with older children reporting less pain from injection than younger children.

CONCLUSION: For children, soaking a simple laceration with 1% lidocaine does not decrease pain from the subsequent lidocaine injection.

Author List

Stewart GM, Simpson P, Rosenberg NM

Author

Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Anesthetics, Local
Child
Child, Preschool
Double-Blind Method
Emergency Service, Hospital
Female
Humans
Injections
Lidocaine
Male
Pain
Pain Measurement
Prospective Studies
Wounds, Penetrating