Topical anesthetics in children: agents and techniques that equally comfort patients, parents, and clinicians

Area of Science:

• Dermatology
• Pediatrics
• Anesthesiology

Background:

• The rise in pediatric outpatient dermatologic surgeries necessitates effective pain management strategies.
• Topical anesthetics offer a noninvasive approach to minimize procedural discomfort in infants and children.
• Local anesthetics, developed since the 1880s, have evolved into various ester- and amide-based formulations.

Purpose of the Study:

• To review current and emerging topical anesthetic preparations for pediatric dermatologic procedures.
• To discuss advancements in transdermal delivery vehicles and combination anesthetic use.
• To highlight agents frequently prescribed and those on the horizon for pediatric populations.

Main Methods:

• Review of existing literature on topical anesthetics in pediatric dermatology.
• Discussion of commonly used agents like eutectic mixture of local anesthetics (EMLA) and ELA-max.
• Exploration of novel delivery systems including iontophoresis and patches.

Main Results:

• Eutectic mixture of local anesthetics (EMLA) remains a frequently prescribed topical anesthetic.
• ELA-max, a lidocaine-based preparation, is gaining popularity, particularly in neonates.
• Emerging options such as amethocaine, tetracaine, iontophoresis, and the S-caine patch show promise.

Conclusions:

• The range of topical anesthetic options for pediatric dermatologic care is expanding.
• Innovations in delivery systems are enhancing the efficacy and applicability of topical anesthetics.
• Continued development is crucial for optimizing pain management in pediatric procedures.