Topical
anesthesia in the form of TAC (
tetracaine,
adrenaline,
cocaine)
solution has been used for
wound repair. This pilot study was designed to determine if the topical
anesthesia achieved using a mixture of
lidocaine (5%) and
epinephrine (1:2000) (TLE) is equivalent to the topical
anesthesia obtained using a
solution of
tetracaine (0.5%),
epinephrine (1: 2000), and
cocaine (10.4%) (TAC). A prospective, randomized, double-blind trial was carried out from May 1992 to August 1992 at a community-based teaching hospital Emergency Department (ED) that receives 50,000 annual visits. Patients with facial or scalp
lacerations suitable for topical
anesthesia presenting to the ED were included when study physicians were in attendance. Exclusion criteria included the presence of a sensory altering substance (eg,
ethanol), age younger than two years,
hypertension, pregnancy,
allergy to any of the study's pharmacological agents,
wounds greater than six hours old, grossly contaminated
wounds, and
wounds longer than six centimeters. Either a TAC or TLE
solution was applied to
lacerations before suturing. The
laceration was repaired and the patient or physician evaluated the degree of
pain from the procedure by using a standardized visual
pain scale. A total of 35 patients were studied. Seventeen patients were in the TLE group; 18 in the TAC group. The mean ages were compared and found to be similar (P = .40) between the two test groups. The
pain scale values, the diameter of tissue blanch around
laceration (halo size), and the time to
laceration repair from the onset of application of
anesthetic were compared and no difference was shown between the TAC and TLE groups.(ABSTRACT TRUNCATED AT 250 WORDS)