Comparison of tetracaine-adrenaline-cocaine (TAC) with topical lidocaine-epinephrine (TLE): Efficacy and cost

Comparative efficacy and costs of various topical anesthetics for repair of dermal lacerations: a systematic review of randomized, controlled trials

“…The traumas were superficial and the length of the dermal injuries ranged from 1.5 to 10 cm. Adler et al 1998 4 [26] Ernst et al 1990 4 [33] Schilling et al 1995 4 [36] Resch et al 1998 3.5 [28] Kuhn et al 1996 3 [14] Smith et al 1996 3 [23] Smith and Barry 1990 3 [22] Vinci and Fish 1996 3 [29] Blackburn et al 1995 2.5 [30] Zempsky and Karasic 1997 2.5 [19] Anderson et al 1990 2 [24] Bonadio and Wagner 1990 2 [32] Ernst et al 1997 2 [27] Schaffer 1985 2 [15] Smith et al 1998 2 [20] Smith et al 1997 (a) 2 [16] Smith et al 1997 (b) 2 [25] White et al 1986 2 [21] Hegenberth et al 1990 0 [2] Pryor et al 1980 0…”

“…A nonblinded RCT that enrolled 467 pediatric patients [21] found a significantly greater analgesic efficacy for Adler et al [31] 60 Patients (z12 y) 15% 8% 77% V7 cm Anderson et al [19] 151 Pediatric (b18 y) 52% 21% 27% b5 cm Blackburn et al [29] 35 Adult + pediatric (N2 y) Yes a Yes a V6 cm Bonadio et al [24] 55 Pediatric (NR) Yes a NR Ernst et al [26] 139 Adult + pediatric (N5 y) 38% 24% 37% 0.7% b5 cm Ernst et al [34] 95 Pediatric (5-17 y) 67% 33% V7 cm Ernst et al [35] 95 Adult (NR) 85% 14% V7 cm Ernst et al [32] 66 Adult + pediatric (N5 y) 45% 15% 36% 1.5-10 cm Hegenberth et al [21] 467 Pediatric (7 mo-18 y) Yes a Yes a Yes a Yes a NR Kuhn et al [28] 180 Adult + pediatric (z6 y) 63% 37% 3-7 cm Pryor et al [2] 158 Patients (10 mo-53 y) NR NR NR NR NR Resch et al [36] 194 Pediatric (NR) Yes a Yes a NR Schaffer [27] 107 Pediatric (V10 y) 79% 21% NR Schilling et al [33] 171 Pediatric (1-17 y) 70% 30% NR Smith et al [15] 180 Pediatric (1-18 y) 42% 33% 24% V5 cm Simth et al [20] 71 Pediatric (2-16 y) 61% 39% V5 cm Smith et al [16] 240 Pediatric (1-18 y) 51% 30% 18% V5 cm Smith et al [14] 240 Pediatric (2-17 y) 56% 24% 20% V5 cm Smith et al [23] 250 Pediatric (15 mo-17 y) 60% 12% 28% NR Vinci et al [22] 156 Pediatric (3-18 y) 66% b 30% 4% NR White et al [25] 68 Adults (N18 y) 32% c NR Zempsky et al [30] 32 Pediatric ( lidocaine infiltration than topical TAC solution. The study did not directly assess pain intensity during wound closure.…”

“…Vinci and Fish [22] concluded that TAC 2 (tetracaine 1.0%, epinephrine 1:2000, cocaine 4.0%) was equivalent to TAC 1 (tetracaine 0.5%, epinephrine 1:2000, cocaine 11.8%). In that study, pain intensity during wound [19] None None Requirement of supplemental lidocaine infiltration, compliance scores, adequacy of anesthesia by probing wound with needle Blackburn et al [29] Pain intensity Faces scale Requirement of supplemental lidocaine infiltration Ernst et al [26] Pain intensity None Anesthetic effectiveness rated by physician (0-10) Ernst et al [34] Pain intensity VAS Physician VAS pain rating and percentage of sutures causing pain Ernst et al [35] Pain intensity Multidimensional pain scale…”

The use of topical anaesthesia during repair of minor lacerations in Departments of Emergency Medicine: A literature review

“…Studies carried out previously highlighted that topical anaesthetics had a poor success rate if their application was limited to a single layer as opposed to sequential layered application (Pryor et al, 1980;Bonadio and Wagner, 1988;Anderson et al, 1990;Carpenter and Mackey, 1992;Grant and Hoffman, 1992;Blackburn et al, 1995;Ernst et al, 1995;Adler et al, 1998;Hollander and Singer, 1999;Priestley et al, 2003). That said, the advantages and efficacy of topical anaesthesia are well documented in the literature.…”

“…The majority of studies looking at the use of topical anaesthetics highlight poor success on trunk and extremity wounds in comparison to scalp and facial wounds (Carpenter and Mackey, 1992;Blackburn et al, 1995;Priestley et al, 2003). Studies carried out previously highlighted that topical anaesthetics had a poor success rate if their application was limited to a single layer as opposed to sequential layered application (Pryor et al, 1980;Bonadio and Wagner, 1988;Anderson et al, 1990;Carpenter and Mackey, 1992;Grant and Hoffman, 1992;Blackburn et al, 1995;Ernst et al, 1995;Adler et al, 1998;Hollander and Singer, 1999;Priestley et al, 2003).…”