Abstract | OBJECTIVE: METHODS: This was a double-blind, randomized clinical trial that included consecutive emergency department patients aged > or = 1 year with clean, non- bite lacerations < or = 6 hours old. At triage the lacerations were randomized to LET solution or a placebo containing epinephrine 1:1,000. At examination an emergency practitioner assessed the laceration edges for the presence of blanching and adequacy of anesthesia to a 27-gauge needlestick. At the practitioner's discretion, supplemental lidocaine was infiltrated through the wound and the patient (or guardian) recorded the pain of infiltration on a 100-mm visual analog scale marked "most pain" at the high end. The mean levels of pain of lidocaine infiltration were compared between groups with a t-test and the proportions of adequately anesthetized wounds were compared with a chi2 test. A sample of 40 patients had 80% power to detect a 20-mm between-group difference in the pain of injection (alpha = 0.05). RESULTS: Of 43 patients enrolled (mostly children and males), 22 received LET and 21 placebo. The groups were similar for baseline characteristics. Lacerations in the LET group were more frequently adequately anesthetized (46% vs 14%, p = 0.03), and LET patients experienced less pain from injection than controls (22 mm vs 42 mm, p = 0.02). CONCLUSIONS: Application of LET by triage nurses is more effective than placebo in adequately anesthetizing simple lacerations in normal hosts and decreases the pain of local anesthetic infiltration.
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Authors | A J Singer, M J Stark |
Journal | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
(Acad Emerg Med)
Vol. 7
Issue 7
Pg. 751-6
(Jul 2000)
ISSN: 1069-6563 [Print] United States |
PMID | 10917323
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anesthetics, Local
- Tetracaine
- Lidocaine
- Epinephrine
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Topics |
- Administration, Topical
- Adolescent
- Adult
- Aged
- Anesthesia, Local
(methods)
- Anesthetics, Local
(administration & dosage)
- Child
- Child, Preschool
- Confidence Intervals
- Double-Blind Method
- Emergency Service, Hospital
- Epinephrine
(administration & dosage)
- Female
- Humans
- Injections, Intramuscular
- Injury Severity Score
- Lacerations
(diagnosis, surgery)
- Lidocaine
(administration & dosage)
- Male
- Middle Aged
- New York
- Pain Measurement
- Preanesthetic Medication
- Reference Values
- Statistics, Nonparametric
- Tetracaine
(administration & dosage)
- Treatment Outcome
- Triage
(methods)
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