Topical anaesthetic versus lidocaine infiltration to allow closure of skin wounds in children

Abstract

A short cut review was carried out to establish whether transthoracic ultrasound can be used to diagnose pneumothoraces in trauma patients. A total of 46 papers were found using the reported search, of which four represented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Topical anaesthesia in children: reducing the need for specialty referral

“…Our study showed a significant reduction in the number of children referred for general anaesthesia. The advantages of topical anaesthesia, while providing effective anaesthesia, include painless application, no needle and no tissue distortion, as occurs after subcutaneous infiltration of local anaesthetic [11][12][13][14].…”

“…As there is a large body of evidence in the literature showing how efficacious and safe LAT gel is for the repair of wounds [11][12][13][14][15], we believed that a randomized controlled trial was not warranted. We wanted all of our patients to benefit from the gel once it was introduced and decided to assess it retrospectively following this.…”

“…Topical anaesthesia facilitates such approaches as explanation of the procedure and distraction techniques. A number of studies have concluded that topical anaesthetic gels are as effective as and less painful to apply than infiltrative anaesthetics [11][12][13][14][15].…”

Clinical Trial for Safety Evaluation of Hyaluronidase as Diffusion Enhancing Adjuvant for Infiltration Analgesia of Skin with Lidocaine

“…14 The infiltration analgesia is made in concentrations of 1% to 5% as an aqueous solution of the hydrochloride, is applied intra-or subcutaneously, and spreads by diffusion in the tissue. 15,16 Two pharmacologic options are practiced to improve the local bioavailability of lidocaine in the tissue.…”

Preliminary Clinical Assessment of Polyvinyl Alcohol-Tetrahydroxyborate Hydrogels as Potential Topical Formulations for Local Anesthesia of Lacerations

“…4 Investigators have considered replacing infiltration entirely with topical anesthesia, brought about, for example, by tetracaine-adrenaline-cocaine-containing formulations and variants thereof. [5][6][7][8] Despite evidence of comparable efficacy, topical application of local anesthetics is still not common in the United Kingdom, possibly due to a perceived lack of efficacy, combined with the prolonged time required for effective anesthesia induction. 9,10 Effective topical anesthesia requires a particular delivery formulation.…”