Abstract | OBJECTIVE: DESIGN: Double-blind, randomised, prospective trial. SETTING: Emergency departments of two tertiary referral hospitals (one specialising in paediatric care) in Adelaide, South Australia, between February 1992 and April 1994. PARTICIPANTS: 181 patients, aged six or older, with simple dermal lacerations less than 5mm deep, not involving mucous membranes or areas with end-arterial blood supply. INTERVENTIONS: Patients received a weight-adjusted dose of either MAC or TAC. OUTCOME MEASURES: Needle-prick testing of wound for pain before suturing, pain ratings by patients and physicians during suturing, signs and symptoms of cocaine toxicity, wound complications and patient preference for topical anaesthesia. RESULTS: Topical anaesthesia was adequate for suturing in 73% of patients (83% or those with head wounds and 56% of those with extremity wounds). MAC and TAC did not differ significantly in efficacy overall or by wound location. Pain ratings from patients treated with MAC and TAC were comparable, as was patients acceptance of topical anesthesia (77%, MAC; 81%, TAC) and the incidence of adverse effects (4% infection rate overall). CONCLUSIONS: Topical anesthesia is a safe and effective means of anaesthetising selected lacerations for suturing. As we found no significant differences in either the efficacy or safety of the two solutions, we believe that MAC can be substituted for the less readily available TAC whenever expedient.
|
Authors | M Kuhn, S O Rossi, J L Plummer, J Raftos |
Journal | The Medical journal of Australia
(Med J Aust)
Vol. 164
Issue 5
Pg. 277-80
(Mar 04 1996)
ISSN: 0025-729X [Print] Australia |
PMID | 8628162
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Anesthetics, Local
- Tetracaine
- Cocaine
- Bupivacaine
- Epinephrine
|
Topics |
- Adolescent
- Anesthesia, Local
- Anesthetics, Local
- Bupivacaine
- Child
- Cocaine
- Dermatologic Surgical Procedures
- Epinephrine
- Humans
- Skin
(injuries)
- Soft Tissue Injuries
(surgery)
- Sutures
- Tetracaine
- Treatment Outcome
|