1. Cocaine‐containing topical anaesthetics versus infiltrated local anaesthetics.

Study	Anaesthetics	Participant self‐reported pain scores	Secondary outcome measures	Incidence of anaesthetic toxicity
Anderson 1990	Topical tetracaine‐epinephrine‐cocaine (TAC) vs infiltrated lidocaine	None	1) Adequate initial anaesthesia (TAC = 89% vs infiltrated local anaesthetic = 79%; P = non‐significant) 2) Physician compliance scale(1 = complete compliance to 4 = continuous resistance) (mean score ± SD: TAC = 1.25 ± 0.57 vs infiltrated local anaesthetic = 1.94 ± 1.12; P < 0.002) 3) Requirement for supplemental lidocaine infiltration (topical TAC = 18% vs infiltrated local anaesthetic = 23%; P = non‐significant)	Not reported
Hegenbarth 1990	Topical TAC vs infiltrated lidocaine	None	1) Adequate initial anaesthesia for facial and scalp lacerations (topical TAC = 81% vs infiltrated local anaesthetic = 87%; P = 0.005). Adequate initial anaesthesia for extremity and trunk wounds (topical TAC = 43% vs infiltrated local anaesthetic = 89%; P < 0.0001)	0/467
Pryor 1980	Topical TAC vs infiltrated lidocaine	None	1) Verbal rating of anaesthetic efficacy (complete: TAC = 84% vs infiltrated local anaesthetic = 88%; P = not reported) 2) Anaesthetic acceptability: Participants 17 years or younger preferred topical TAC (P < 0.005); results showed no differences between the 2 anaesthetic groups among participants older than 17 years of age	Not reported
Smith 1996	Topical TAC vs infiltrated lidocaine	Patient‐reported VAS (100 mm) pain scores (mean scores: topical TAC = 12.0 vs infiltrated local anaesthetic = 26.3; P = NS)	1) Observer‐reported VAS pain scores 2) Observer‐reported Likert pain scores 3) Oberver‐rated Restrained Infants and Children Disress Rating Scale 4). Suture technician‐rated anaesthetic effectiveness	Not reported
Smith 1997a	Topical TAC vs infiltrated lidocaine	None	1) Observer‐reported VAS pain scores (suture technicians, research assistants, videotape reviewers) 2) Observer‐reported Lickert (1‐7) pain scores (parents, suture technicians) 3) Requirement for supplemental lidocaine infiltration (See Characteristics of included studies for data.)	Not reported
Kendall 1996	Topical (epinephrine‐cocaine) AC vs infiltrated lidocaine	The study pooled patient‐reported VAS and Wong‐Baker Faces pain scores (mean score: topical AC = 4.50 vs infiltrated local anaesthetic = 4.40; P = NS)	1) Physician‐rated VAS pain scores 2) Parent‐rated VAS scores 3) Parents' rating of overall acceptability of procedure	0/107

AC: epinephrine (adrenaline) and cocaine; BN: bupivacaine‐noradrenaline; BP: blood pressure; cm: centimetre; c/w:compared with; ED: emergency department; EMLA: Eutectic Mixture of Local Anesthetics (lidocaine and prilocaine); EN: etidocaine‐noradrenaline; LAT: lidocaine, epinephrine and tetracaine (same as LET); LE: lidocaine and epinephrine; LET: same as LAT; LG: local gel; LI: local infiltration; MAC: bupivacaine 0.5%, epinephrine 1:2000, cocaine 10.0%; mm: milli‐metre; MN: mepivacaine‐noradrenaline; PN: prilocaine‐noradrenaline; N: number; NS: not significant; P = P value; PP: prilocaine, phenylephrine; RCT: randomized controlled trial; RICDRS: Restrained Infants and Children Distress Rating Scale; SD: standard deviation; SE: standard error; TA: tetracaine and epinephrine; TAC: tetracaine, epinephrine and cocaine; TLP: tetracaine, lidocaine and phenylephrine; TP: tetracaine and phenylephrine; VAS: visual analogue scale; vs: versus; w/w: weight per weight.