Skip to main content
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1997 Aug;167(2):79–81.

Topical lidocaine adrenaline tetracaine (LAT gel) versus injectable buffered lidocaine for local anesthesia in laceration repair.

A A Ernst 1, E Marvez-Valls 1, T G Nick 1, T Mills 1, L Minvielle 1, D Houry 1
PMCID: PMC1304430  PMID: 9291744

Abstract

The objective of the study was to compare topical lidocaine adrenaline tetracaine (LAT gel) with injectable buffered lidocaine with epinephrine regarding pain of application or injection and anesthesia effectiveness. The study was a randomized prospective comparison trial in an urban emergency department. Physicians and patients ranked the pain of application, injection, and suturing according to a 10-cm visual analog scale. Sixty-six patients were entered, 33 in the LAT gel group and 33 in the injectable buffered lidocaine group. Injection was found to be significantly more painful than application of gel (P < 0.001). For anesthesia effectiveness, there was no difference according to patients (P = 0.48) or physicians (P = 0.83) for topical vs injectable forms. The number of sutures causing pain was not statistically different in the two groups (P = 0.28). In conclusion, LAT gel compared favorably with injectable buffered lidocaine for local anesthesia effectiveness and was significantly less painful to apply. It may be the preferred local anesthetic for this reason.

Full text

PDF
79

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bonadio W. A., Wagner V. Efficacy of TAC topical anesthetic for repair of pediatric lacerations. Am J Dis Child. 1988 Feb;142(2):203–205. doi: 10.1001/archpedi.1988.02150020105040. [DOI] [PubMed] [Google Scholar]
  2. Christoph R. A., Buchanan L., Begalla K., Schwartz S. Pain reduction in local anesthetic administration through pH buffering. Ann Emerg Med. 1988 Feb;17(2):117–120. doi: 10.1016/s0196-0644(88)80293-2. [DOI] [PubMed] [Google Scholar]
  3. Ernst A. A., Marvez-Valls E., Nick T. G., Wahle M. Comparison trial of four injectable anesthetics for laceration repair. Acad Emerg Med. 1996 Mar;3(3):228–233. doi: 10.1111/j.1553-2712.1996.tb03425.x. [DOI] [PubMed] [Google Scholar]
  4. Ernst A. A., Marvez-Valls E., Nick T. G., Weiss S. J. LAT (lidocaine-adrenaline-tetracaine) versus TAC (tetracaine-adrenaline-cocaine) for topical anesthesia in face and scalp lacerations. Am J Emerg Med. 1995 Mar;13(2):151–154. doi: 10.1016/0735-6757(95)90082-9. [DOI] [PubMed] [Google Scholar]
  5. Ernst A. A., Marvez E., Nick T. G., Chin E., Wood E., Gonzaba W. T. Lidocaine adrenaline tetracaine gel versus tetracaine adrenaline cocaine gel for topical anesthesia in linear scalp and facial lacerations in children aged 5 to 17 years. Pediatrics. 1995 Feb;95(2):255–258. [PubMed] [Google Scholar]
  6. Hegenbarth M. A., Altieri M. F., Hawk W. H., Greene A., Ochsenschlager D. W., O'Donnell R. Comparison of topical tetracaine, adrenaline, and cocaine anesthesia with lidocaine infiltration for repair of lacerations in children. Ann Emerg Med. 1990 Jan;19(1):63–67. doi: 10.1016/s0196-0644(05)82145-6. [DOI] [PubMed] [Google Scholar]
  7. McKay W., Morris R., Mushlin P. Sodium bicarbonate attenuates pain on skin infiltration with lidocaine, with or without epinephrine. Anesth Analg. 1987 Jun;66(6):572–574. [PubMed] [Google Scholar]
  8. Morris R., McKay W., Mushlin P. Comparison of pain associated with intradermal and subcutaneous infiltration with various local anesthetic solutions. Anesth Analg. 1987 Nov;66(11):1180–1182. [PubMed] [Google Scholar]
  9. Pryor G. J., Kilpatrick W. R., Opp D. R. Local anesthesia in minor lacerations: topical TAC vs lidocaine infiltration. Ann Emerg Med. 1980 Nov;9(11):568–571. doi: 10.1016/s0196-0644(80)80227-7. [DOI] [PubMed] [Google Scholar]
  10. Schilling C. G., Bank D. E., Borchert B. A., Klatzko M. D., Uden D. L. Tetracaine, epinephrine (adrenalin), and cocaine (TAC) versus lidocaine, epinephrine, and tetracaine (LET) for anesthesia of lacerations in children. Ann Emerg Med. 1995 Feb;25(2):203–208. doi: 10.1016/s0196-0644(95)70325-x. [DOI] [PubMed] [Google Scholar]
  11. Scott J., Huskisson E. C. Graphic representation of pain. Pain. 1976 Jun;2(2):175–184. [PubMed] [Google Scholar]
  12. Todd K. H., Funk J. P. The minimum clinically important difference in physician-assigned visual analog pain scores. Acad Emerg Med. 1996 Feb;3(2):142–146. doi: 10.1111/j.1553-2712.1996.tb03402.x. [DOI] [PubMed] [Google Scholar]
  13. Wightman M. A., Vaughan R. W. Comparison of compounds used for intradermal anesthesia. Anesthesiology. 1976 Dec;45(6):687–689. doi: 10.1097/00000542-197612000-00024. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES