title: Topical anesthesia for pediatric lacerations: a randomized trial of lidocaine-epinephrine-tetracaine solution versus gel.
abstract: OBJECTIVE
  To compare the adequacy and efficacy of anesthesia experienced with lidocaine-epinephrine-tetracaine (LET) solution versus LET gel during suturing of uncomplicated lacerations on the face or scalp in children.
  
  
  METHODS
  Two hundred children with lacerations of the face and scalp requiring suturing were enrolled in this blinded, randomized controlled trial, in the emergency department of a university-affiliated children's hospital. After the application of anesthetic solution or gel, adequacy of anesthesia was determined before suturing. Efficacy of anesthesia during laceration repair was determined by the length of time after removal of the topical anesthetic to the first sign of discomfort that required additional anesthesia or until suture completion.
  
  
  RESULTS
  Adequacy of initial anesthesia was equivalent between LET solution and LET gel. There was a significant difference in efficacy of anesthesia between the LET formulations. There were more patients with complete anesthesia (85% versus 76%), fewer persons with partial anesthesia (5% versus 21%), and more persons with incomplete anesthesia (9% versus 3%) in the gel group.
  
  
  CONCLUSIONS
  LET gel is at least as effective as LET solution and possesses theoretical advantages for topical anesthesia during suturing of uncomplicated lacerations on the face and scalp in children.
authors.affiliation: Emergency and Clinical Pharmacy Departments, Children's Hospitals and Clinics-Minneapolis, MN, USA.
authors.forename: K
authors.initials: K
authors.lastname: Resch
authors.forename: C
authors.initials: C
authors.lastname: Schilling
authors.forename: B D
authors.initials: BD
authors.lastname: Borchert
authors.forename: M
authors.initials: M
authors.lastname: Klatzko
authors.forename: D
authors.initials: D
authors.lastname: Uden
mesh_terms: D000367:Age Factors; D019162:Anesthetics, Combined / Q000737:chemistry / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000737:chemistry / Q000627:therapeutic use*; D002626:Chemistry, Pharmaceutical; D002648:Child; D004837:Epinephrine / Q000737:chemistry / Q000627:therapeutic use*; D005151:Facial Injuries / Q000628:therapy*; D005260:Female; D005782:Gels; D006801:Humans; D008012:Lidocaine / Q000737:chemistry / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D012535:Scalp / Q000293:injuries*; D016037:Single-Blind Method; D012996:Solutions; D013536:Suture Techniques; D013748:Tetracaine / Q000737:chemistry / Q000627:therapeutic use*; D013997:Time Factors; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D005782:Gels; C111497:LET, anesthetic; D012996:Solutions; D013748:Tetracaine; D008012:Lidocaine; D004837:Epinephrine