Comparison of Topical Anesthetics for Radiofrequency Ablation of Achrocordons: Eutectic Mixture of Lignocaine/Prilocaine versus Lidocaine/Tetracaine

Abstract

Introduction. Topical application of local anesthetics is currently considered to be the easiest, most effective, and convenient way for treatment of patients who may be undergoing superficial dermatosurgical procedures. Materials and Methods. This study compares the anesthetic potential of 2.5% lidocaine and 2.5% prilocaine topical cream with 7% lignocaine and 7% tetracaine combination cream for radio ablative dermatosurgery when applied, under occlusion, for 30 minutes. 40 subjects of achrocordons were enrolled in this split-side randomized trial. Result. The pain severity experienced by subjects in terms of visual analogue scale score was significantly lesser for lignocaine/tetracaine combination cream as compared to lidocaine/prilocaine combination. Conclusion. This small study proves the efficacy of lidocaine/tetracaine combination as a topical anesthetic cream when applied for a short time interval of 30 minutes. This will help a dermatosurgeon to perform various dermatological procedures in a better and efficient manner with a shorter waiting period for analgesia to set in.

Preparation, Characterization, and In Vitro Evaluation of Cream & Gel Formulations Containing Lidocaine and Tetracaine

“…heating (generating a skin temperature of 39 to 41 °C) during the application period [5]. Topical anesthesia with a waiting time of 30 minutes would be more viable and convenient to use in dermatology procedures compared to the one requiring a downtime of at least 1 hour [2].…”

“…Many topical anesthetic creams have become available over the last few years and they claim to provide a long-lasting anesthetic effect after topical use on the skin. The potential benefits for patch and cream delivery systems over injection include increased safety, the convenience of use, ease of disposal, reduced drug loading, and no tissue dissention [2]. But intact skin presents a significant barrier to available topical anesthetic preparations.…”

“…EMLA ® cream is an emulsion in which the oil phase is a eutectic mixture of 2.5% lidocaine and 2.5% prilocaine (LP). EMLA ® cream is a recommended alternative topical anesthetic for radiofrequency ablation if applied under occlusion to the skin at least 1-2 h before the procedure [2]. With EMLA ® , analgesia is achieved to a depth of 3 mm after 60 min and a maximum depth of 5 mm after 120 min of EMLA ® exposure, EMLA ® has been shown to provide effective anesthesia for several different procedures but requires occlusion and does not provide adequate anesthesia at peripheral skin margins [4].…”

Topical local anesthesia: focus on lidocaine–tetracaine combination

“…In 2014, Gahalaut et al compared the anesthetic potential of 2.5% lidocaine and 2.5% prilocaine topical cream with 7% lidocaine and 7% tetracaine combination cream when applied under occlusion for 30 minutes for radioablative dermatosurgery. 17 Forty subjects of achrocordons were enrolled in this split-side randomized trial. The authors found that pain severity experienced by subjects in terms of VAS score was significantly less for LT combination cream than for the lidocaine–prilocaine combination.…”

Real‐life experience of a lidocaine/tetracaine self‐occluding topical anesthetic for dermatological procedures

“…This novel self-occluding system prevents the use of occlusive dressings for lengthy periods. 2,3 Numerous clinical trials and studies have demonstrated the efficacy and safety of Pliaglis ® in several dermatological procedures, including pulsed dye laser, 2,4 non-ablative laser, 5 ablative laser resurfacing, 6 Nd:YAG laser treatment of leg veins, 7,8 laser-assisted hair removal, 9 tattoo removal, 10 radiofrequency ablation of achrocordons, 11 treatment with hyaluronic acid, 12 and other dermal fillers, 13 and photodynamic therapy. 14 A very recent randomized, controlled trial has also proved the efficacy of Pliaglis ® for fractional micro-ablative laser resurfacing.…”