Heated lidocaine/tetracaine patch (Synera™, Rapydan™) compared with lidocaine/prilocaine cream (EMLA®) for topical anaesthesia before vascular access

Sawyer, Jason; Febbraro, Salvatore; Masud, Salman; Ashburn, Michael A.; Campbell, John C.

doi:10.1093/bja/aen364

Cited by 85 publications

(70 citation statements)

References 12 publications

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“…Upon removal from the protective pouch and exposure to atmospheric oxygen, an exothermic reaction occurs causing the patch heat up and increasing skin temperature bỹ 5C [173]. The effectiveness of the heat-aided patches was first demonstrated in adults [174], and the device was commercialized as Synera TM (USA) or Rapydan TM (Europe) and approved for paediatric use [175]. The surface area of the patch is 50 cm 2 but drug is delivered through only 10 cm 2 .…”

Section: Innovative Methods For Paediatric Transdermal Drug Deliverymentioning

confidence: 99%

Effective use of transdermal drug delivery in children

Delgado‐Charro

Guy

2014

Advanced Drug Delivery Reviews

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Section: Innovative Methods For Paediatric Transdermal Drug Deliverymentioning

confidence: 99%

Effective use of transdermal drug delivery in children

Delgado‐Charro

Guy

2014

Advanced Drug Delivery Reviews

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“…These studies showed that the warm lidocaine and tetracaine patch had a more rapid analgesic effect than EMLA cream, acting in 30 minutes instead of 60 minutes. However, apart from the time it took for them to start providing pain relief, both formulations were equally effective (9,10).…”

Section: Accepted Articlementioning

confidence: 99%

“…We know how long it would be before they took effect, so the warm lidocaine and tetracaine patches and the EMLA cream were applied at least 30 and 60 minutes, respectively, before the needle procedure (10). The topical analgesics were removed immediately before the needle procedure.…”

Section: Accepted Articlementioning

confidence: 99%

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First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

et al. 2017

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Accepted ArticleThis article is protected by copyright. All rights reserved. Aim: More than 50% of children report apian during venipuncture or intravenous cannulation and using local anaesthetics before needle procedures can lead to different success rates. This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream. Methods:We conducted this multicentre randomised controlled trial at three tertiary-level children's hospitals in Italy in 2015. Children aged 3-10 years were enrolled in an emergency department, paediatric day hospital and paediatric ward and randomly allocated to receive a warm lidocaine and tetracaine patch or EMLA cream. The primary outcome was the success rate at the first attempt. Results:The analysis included 172 children who received a warm lidocaine and tetracaine patch and 167 who received an EMLA cream. The needle procedure was successful at the first attempt in 158 children (92.4%) who received the warm patch and in 142 children (85.0%) who received the cream (p=0.03). The pain scores were similar in both groups. Conclusion:This study showed that the first-time needle procedure success was 7.4% higher in children receiving a warm lidocaine and tetracaine patch than EMLA cream. Accepted ArticleThis article is protected by copyright. All rights reserved.Keywords: eutectic mixture of lidocaine and tetracaine cream; local anaesthetic; needle procedure; procedural success rate; warm lidocaine and tetracaine patch Key notes:• Applying local anesthetics may influence success rates in children undergoing painful needle procedures.• We compared how many needles were inserted at the first attempt when children received a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream.• The three Italian hospitals who took part reported that the success rate was higher in children treated with the warm patch (92.4%) than the cream (85.0%). AbbreviationsARR, absolute risk reduction; CI, confidence intervals; EMLA, eutectic mixture of lidocaine and tetracaine; IQR, interquartile ranges; NNT, number need to treat; RR, relative risks

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“…This anesthetic is available commercially as a 2 or 3% solution with 1:50,000 to 1:100,000 epinephrine [4][5][6][7] . Different forms of lidocaine have been developed for use as topical anesthetics.…”

Section: Introductionmentioning

confidence: 99%

The <i>in vitro</i> and <i>in vivo</i> effects of a fast-dissolving mucoadhesive bi-layered strip as topical anesthetics

et al. 2016

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To overcome pain on injection, the dentist can apply a topical anesthetic spray. Despite the convenience, it is not easy to apply it locally. So, we developed an oral mucoadhesive bi-layer film containing an anesthetic. We used polyvinylpyrrolidone (PVP)/ hydroxypropyl methylcellulose (HPMC) and HPMC-only layer as the drug-containing layer and ethyl cellulose (EC) as the backing layer. The lidocaine released was tested in vitro together with the adhesion time and cytotoxicity of the film. Mucosa permeability was tested in vivo. Statistical analysis was performed, with p at 0.05 taken to be significant. The lidocaine was released significantly faster in the PVP/HPMC than HPMC-only group and 80% of the drug was released within 1 min (p<0.05) and they attached at least 3 h. The test groups showed no toxicity and the drug effectively permeated the mucosa (p<0.05). We suggest this new mucoadhesive anesthetic may reduce dental phobia.

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Heated lidocaine/tetracaine patch (Synera™, Rapydan™) compared with lidocaine/prilocaine cream (EMLA®) for topical anaesthesia before vascular access

Cited by 85 publications

References 12 publications

Effective use of transdermal drug delivery in children

Effective use of transdermal drug delivery in children

First‐time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream

The <i>in vitro</i> and <i>in vivo</i> effects of a fast-dissolving mucoadhesive bi-layered strip as topical anesthetics

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