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

Eidelman, Anthony; Weiss, Jocelyn M.; Enu, Ikay K; Lau, Joseph; Carr, Daniell B.

doi:10.1016/j.jclinane.2004.05.006

Cited by 38 publications

(27 citation statements)

References 39 publications

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“…Topical anaesthesia for wound closure can avoid the distress caused by intradermal injection of local anaesthetic, but cocaine-containing preparations are no longer recommended (Eidelman, Weiss, Enu et al, 2005). Topical anaesthetics, such as lignocaine-adrenalineamethocaine solutions were safe and effective in children (Schilling et al, 1995 Level II;Smith et al, 1997 Level II;White et al, 2004 Level III-1), and had equivalent or superior efficacy when compared with intradermal administration (Eidelman, Weiss, Enu et al, 2005 Level I).…”

Section: Laceration Repairmentioning

confidence: 99%

“…Topical anaesthetics, such as lignocaine-adrenalineamethocaine solutions were safe and effective in children (Schilling et al, 1995 Level II;Smith et al, 1997 Level II;White et al, 2004 Level III-1), and had equivalent or superior efficacy when compared with intradermal administration (Eidelman, Weiss, Enu et al, 2005 Level I). Application of topical anaesthetic solution to wounds at triage reduced treatment time (31 minutes less than controls) (Priestley et al, 2003 Level II) and reduced pain associated with subsequent intradermal injection of lignocaine (Singer & Stark, 2000 Level II).…”

Section: Laceration Repairmentioning

confidence: 99%

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Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Laceration Repairmentioning

confidence: 99%

Section: Laceration Repairmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…In practice, this is likely to vary, depending on the individual, the nature of the wound, and its site, but clinical evidence of the validity of this approach has been demonstrated. 6,8 To assess the extent of drug release from these systems, in vitro release from different formulations containing 4% lidocaine hydrochloride was examined. Lidocaine was chosen as a model drug because it is widely used and moderately potent, with a quick onset and a reasonable duration of action.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

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

McCarron

Murphy

Little

et al. 2011

Academic Emergency Medicine

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Objectives: The aim of this study was to assess a novel semisolid material as a potential topical drug delivery system for acute laceration. The objectives were to correlate physical characterization data using rheologic studies and to compare with clinical assessment of performance in an emergency department (ED).Methods: Polyvinyl alcohol (PVA) hydrogels, cross-linked using tetrahydroxyborate (THB), were characterized using texture profile analysis. Formulation samples were applied to acute lacerations presented to the ED and factors, such as in vivo residency time and cohesive removal, were assessed.Results: Viscosity was shown to be related to mechanical characteristics, whereas adhesiveness depended on the THB concentration. Residence in, and clean removal from, lacerations was evaluated on 29 patients. Formulation F3 (10.0% PVA, 2.5% w ⁄ w THB) displayed the most appropriate characteristics for clinical use by scoring highest in qualitative assessments. Other formulations exhibited difficulties in application and removal due to excessive adhesiveness. The release of a model local anesthetic drug was proportional to the concentration of drug incorporated, but was not substantially affected by small changes in the formulation constituents.

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“…Fear and anxiety alter patients' perception of pain, especially in children, and the combination of anxiolytics, behaviour modification and benzodiazepines, such as midazolam, may be an important adjuvant to skin infiltration with buffered lidocaine to improve patient and parent satisfaction (11,12). Topical local anaesthetics can be used for repair of dermal lacerations, placement of epidural catheters and spinal puncture; however, infiltration with lidocaine is usually required for optimal analgesia (13). Topical local anaesthetics are also commonly used for intravenous cannulation, especially in children, despite the significant cost.…”

Section: Commentary By Todd J Kilbaughmentioning

confidence: 99%

Commentary on ‘Adjusting the pH of lidocaine for reducing pain on injection’

Kilbaugh

2012

Evid.‐Based Child Health

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This is a commentary of Cochrane review, published in this issue of EBCH, first published as: Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R. Adjusting the pH of lidocaine for reducing pain on injection. Cochrane Database of Systematic Reviews 2010, Issue 12. Art. No.: CD006581. DOI:10.1002/14651858.CD006581.pub2.Further information for this Cochrane review is available in this issue of EBCH in the accompanying Summary article. Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration

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

Cited by 38 publications

References 39 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

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

Commentary on ‘Adjusting the pH of lidocaine for reducing pain on injection’

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