Comparative Study of the Efficacy of Four Topical Anesthetics

Friedman, Paul M.; Fogelman, Joshua P.; Nouri, Keyvan; Levine, Vicki J.; Ashinoff, Robin

doi:10.1046/j.1524-4725.1999.99138.x

Cited by 118 publications

(98 citation statements)

References 21 publications

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“…ELA-max is superior to tetracaine and betacaine-LA at 60 minutes, while EMLA ® is superior to betacaine-LA at 60 minutes, which is in partial agreement with our prediction. The relative potency after removal is obtained from the mean pain scores 30 minutes after removal of the topical anaesthetics [29,30]. ELA-max and EMLA ® are superior to tetracaine and betacaine-LA 30 minutes after the 60-minute application period, which is in partial agreement with our prediction.…”

Section: Calculation Results and Discussionsupporting

confidence: 81%

“…The predictions have been compared with experimental results [29,30]. The relative potency is obtained from the mean pain scores after application of topical anaesthetics for 60 minutes [29,30]. ELA-max is superior to tetracaine and betacaine-LA at 60 minutes, while EMLA ® is superior to betacaine-LA at 60 minutes, which is in partial agreement with our prediction.…”

Section: Calculation Results and Discussionsupporting

confidence: 64%

“…the eutectic mixture of local anaesthetics (EMLA ® , lidocaine-prilocaine 2.5/2.5% w [28]). However, mixtures of dissimilar anaesthetics are also used, e.g., betacaine-LA (lidocaine-prilocaine-dibucaine) [29] and S-caine (1:1 lidocaine-tetracaine eutectic mixture) [30]. The predictions for topical anaesthetics and ice, both not included in the models, are included in Table 3.…”

Section: Calculation Results and Discussionmentioning

confidence: 99%

“…The predictions for topical anaesthetics and ice, both not included in the models, are included in Table 3. The predictions have been compared with experimental results [29,30]. The relative potency is obtained from the mean pain scores after application of topical anaesthetics for 60 minutes [29,30].…”

Section: Calculation Results and Discussionmentioning

confidence: 99%

“…Although EMLA ® is more potent than ice, ice has advantages in easy of use, fast action, and is less expensive than EMLA ® [31]. [29]. b From mean pain scores 30 minutes after the 60-minute application period of anaesthetics [29].…”

Section: Calculation Results and Discussionmentioning

confidence: 99%

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Periodic Classification of Local Anaesthetics (Procaine Analogues)

Torrens

Castellano

2006

IJMS

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Algorithms for classification are proposed based on criteria (information entropy and its production). The feasibility of replacing a given anaesthetic by similar ones in the composition of a complex drug is studied. Some local anaesthetics currently in use are classified using characteristic chemical properties of different portions of their molecules. Many classification algorithms are based on information entropy. When applying these procedures to sets of moderate size, an excessive number of results appear compatible with data, and this number suffers a combinatorial explosion. However, after the equipartition conjecture, one has a selection criterion between different variants resulting from classification between hierarchical trees. According to this conjecture, for a given charge or duty, the best configuration of a flowsheet is the one in which the entropy production is most uniformly distributed. Information entropy and principal component analyses agree. The periodic law of anaesthetics has not the rank of the laws of physics: (1) the properties of anaesthetics are not repeated; (2) the order relationships are repeated with exceptions. The proposed statement is: The relationships that any anaesthetic p has with its neighbour p + 1 are approximately repeated for each period.

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Section: Calculation Results and Discussionsupporting

confidence: 81%

Section: Calculation Results and Discussionsupporting

confidence: 64%

Section: Calculation Results and Discussionmentioning

confidence: 99%

Section: Calculation Results and Discussionmentioning

confidence: 99%

Section: Calculation Results and Discussionmentioning

confidence: 99%

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Periodic Classification of Local Anaesthetics (Procaine Analogues)

Torrens

Castellano

2006

IJMS

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Laser-Assisted Penetration of Topical Anesthetic in Adults

Baron¹

2003

Arch Dermatol

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Objective: To determine whether pretreatment of skin with erbium:YAG (Er:YAG) laser-assisted delivery facilitates the penetration of lidocaine cream to provide anesthesia suitable for needlesticks after just 5 minutes.Design: Trial 1 was a double-blind randomized controlled trial, whereas trial 2 was a nonblinded randomized controlled trial. Setting:The study was conducted in 2 facilities, an academic and a private clinical research unit.Participants: A total of 320 healthy volunteers, aged 18 to 65 years and of any Fitzpatrick skin phototype.Interventions: Trial 1 involved an Er:YAG laser pretreatment to disrupt the stratum corneum followed by an application of 4% lidocaine cream on one arm, and a laser pretreatment plus placebo on the other arm. Trial 2 involved an application of 4% lidocaine cream alone on one arm, and a laser pretreatment followed by an application of 4% lidocaine cream on the other arm.Main Outcome Measure: Self-reported pain perception on a 100-mm visual analog scale after quick insertion and removal of a 25-gauge hypodermic needle on the treatment sites.Results: Data from the 2 trials showed that there was a 62% pain reduction with laser pretreatment plus lidocaine compared with laser pretreatment plus placebo, and a 61% pain reduction with laser pretreatment plus lidocaine, compared with lidocaine alone. The decrease in pain in both trials was statistically significant (PϽ.001). Adverse events reported 48 hours after treatment were few and mild. Conclusion:Treatment with the Er:YAG laser followed by lidocaine cream is a safe, effective, and efficient means of inducing skin anesthesia that significantly reduces the pain of hypodermic needle insertion.

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