title: Lidocaine iontophoresis for topical anesthesia before dermatologic procedures in children: a randomized controlled trial.
abstract: Local anesthesia by injection in pediatric patients undergoing dermatologic procedures is not well received because of the pain of injection and the fear of needles. Lidocaine iontophoresis is a method of topical anesthesia where lidocaine is driven into the skin under the influence of electric current. We performed a prospective double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine. Sixty children requiring dermatologic procedures were enrolled (50 shave biopsy, 7 curettage, 2 injection, 1 punch biopsy). Twenty-nine of 31 patients in the lidocaine group versus 2 of 29 placebo patients required no supplemental anesthesia (p < 0.001). The pain reported by the patients on the Oucher pain scale subsequent to the procedure was significantly lower in the lidocaine group (p < 0.001). Investigators and parents also rated pain lower in the lidocaine group (p < 0.001). Blanching and/or erythema occurred in 58 of 60 patients, but resolved within 1 hour in all patients. There were no other adverse events. Lidocaine iontophoresis is a safe and effective method of topical anesthesia prior to dermatologic procedures in children.
authors.affiliation: Department of Pediatrics, University of Connecticut School of Medicine, Hartford, CT, USA. wzempsk@ccmckids.org
authors.forename: William T
authors.initials: WT
authors.lastname: Zempsky
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Parkinson
mesh_terms: D000293:Adolescent; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001706:Biopsy / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003475:Curettage / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007478:Iontophoresis; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine