title: Comparing lignocaine-adrenaline-tetracaine gel with lignocaine infiltration for anesthesia during repair of lacerations: A randomized trial.
abstract: BACKGROUND
  This study aimed to compare the topical anesthetic lignocaine, adrenaline, and tetracaine (LAT) (4% lignocaine, 1:2 000 adrenaline, 1% tetracaine) with the conventional lignocaine infiltration(LI) for repair of minor lacerations, for the comfort of anesthetic administration, efficacy, adverse effects and cost.
  
  
  METHODS
  This was a prospective randomized clinical trial. Forty Asian patients who required toilet and suture for minor lacerations in the emergency department of the Singapore General Hospital over a 4-month period. The patients were assigned randomly to 2 arms of treatment. The first was the LAT gel group who had LAT gel applied to the laceration prior to suturing. The second was the control group in whom the anesthetic administered was lignocaine infiltration (LI) via a syringe. The pain of the process of administering anesthetic and efficacy of anesthesia were scored using the visual pain scale included within. The efficacy of LAT vs. lignocaine infiltration as an anesthetic prior to the toilet and suture of minor lacerations and complications of therapy.
  
  
  RESULTS
  Twenty patients were randomized to LAT gel and 16 to LI on an intention to treat analysis. The mean pain score by patients in the LAT gel group was 2.5 (0.52 SE), and 2.5 (0.58 SE) in the LI group. The pain score for pain during application of the anesthetic was 1.5 (0.40) in the LAT gel group, and 3.5 (0.46) in the LI group. There was no difference in complications between the LAT and LI groups.
  
  
  CONCLUSIONS
  LAT gel prior to the toilet and suture of minor lacerations is proven to be as efficacious as LI in terms of patient comfort and effectiveness of anesthesia. The complications are also comparable to those treated with LI.
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, 169608 Singapore.
authors.forename: Jean Mh
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, 169608 Singapore.
authors.forename: Nina
authors.initials: N
authors.lastname: Laxmikantha
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, 169608 Singapore.
authors.forename: Marcus E H
authors.initials: ME
authors.lastname: Ong
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, 169608 Singapore.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Wong
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, 169608 Singapore.
authors.forename: Jeremy Cp
authors.initials: JC
authors.lastname: Wee
keywords: Emergency department; Lacerations; Lignocaine infiltration; Pain score