title: An interesting case of a unilaterally dilated pupil.
abstract: Facial lacerations from minor trauma are a common presenting complaint to the emergency department. With the increasing availability of topical anesthetics, there is a decrease in the need for injectable local anesthetic and sedation services, facilitating the ease of facial laceration repairs for young children. One such topical anesthetic is a widely used pharmacy preparation of lidocaine 4%-epinephrine 0.1%-tetracaine 0.5% gel (LET). Although the use of LET has decreased the need for injectable lidocaine and sedation for facial lacerations, both of which can be unpleasant for children with potentially life-threatening adverse events, it may still lead to unexpected and untoward adverse events. We explore here a little-known adverse effect of LET in a child who presented to a pediatric emergency department with an eyelid laceration after minor head trauma.
authors: Children's Hospital of Philadelphia, PA, USA. galap@email.chop.edu
authors: Payal Kadia
authors: PK
authors: Gala
authors: Frederick M
authors: FM
authors: Henretig
authors: Elizabeth R
authors: ER
authors: Alpern
authors: Esther M
authors: EM
authors: Sampayo
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects*; D015875:Anisocoria / Q000139:chemically induced* / Q000175:diagnosis; D001930:Brain Injuries / Q000175:diagnosis; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D005129:Eye Foreign Bodies / Q000150:complications / Q000175:diagnosis; D005143:Eyelids / Q000293:injuries / Q000601:surgery; D005151:Facial Injuries / Q000175:diagnosis / Q000628:therapy; D005782:Gels; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D009917:Orbital Fractures / Q000150:complications / Q000000981:diagnostic imaging; D010098:Oxycodone / Q000627:therapeutic use; D011007:Pneumocephalus / Q000209:etiology; D011859:Radiography; D013536:Suture Techniques; D013748:Tetracaine / Q000008:administration & dosage / Q000009:adverse effects*; D015845:Tonic Pupil / Q000175:diagnosis
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D006993:Hypnotics and Sedatives; C111497:LET, anesthetic; D013748:Tetracaine; D008012:Lidocaine; D010098:Oxycodone; D004837:Epinephrine