Lidocaine-prilocaine cream versus tetracaine gel for procedural pain in children.
OBJECTIVE
To determine the relative efficacy of lidocaine-prilocaine and tetracaine for procedural pain in children.


METHODS
Systematic review was performed (MEDLINE1990-June 2001) of all studies comparing the efficacy of these 2 modalities of pain relief in children undergoing painful cutaneous procedures. Search terms included lidocaine, prilocaine, tetracaine, and anesthesia.


RESULTS
Eight studies compared lidocaine-prilocaine with tetracaine in children for 4 different procedures: intravenous cannulation, venipuncture, Port-a-Cath puncture, and laser therapy. When used as labeled (60 min for lidocaine-prilocaine, 30 min for tetracaine), the 2 modalities provided similar analgesic efficacy. When both anesthetics were applied for a similar duration of time (40 min, 60 min, 2 h), tetracaine provided superior anesthesia. Tetracaine was commonly associated with erythema, and lidocaine-prilocaine was associated with blanching of the skin.


CONCLUSIONS
Lidocaine-prilocaine and tetracaine appear to be comparable for procedural pain relief when used as recommended. Tetracaine is more efficacious than lidocaine-prilocaine when both anesthetics are applied for the same amount of time.
Taddio
Anna
A
Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.
Gurguis
Mona G Y
MG
Koren
Gideon
G
D000287:Administration, Topical; D000293:Adolescent; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005782:Gels; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000627:therapeutic use*; D016239:MEDLINE; D009824:Ointments; D010146:Pain / Q000517:prevention & control; D011318:Prilocaine / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013748:Tetracaine / Q000627:therapeutic use*
D000779:Anesthetics, Local; D005782:Gels; D009824:Ointments; D011318:Prilocaine; D013748:Tetracaine; D008012:Lidocaine