Related Experiment Video

Updated: Sep 23, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
07:22

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

Application of topical local anesthetic at triage reduces treatment time for children with lacerations: a randomized

Stephen Priestley1, Anne-Maree Kelly, Linda Chow

  • 1Department of Emergency Medicine, Sunshine Hospital, 176 Furlong Road, St. Albans 3021, Melbourne, Victoria, Australia. stephen.priestley@wh.org.au

Annals of Emergency Medicine
|June 27, 2003
PubMed

Insights

Applying topical local anesthetic (ALA) at triage significantly reduces treatment time for children with simple lacerations. This intervention streamlines care without increasing the need for sedation in pediatric emergency departments.

Area of Science:

  • Pediatric Emergency Medicine
  • Wound Management
  • Anesthesiology

Background:

  • Timely and effective treatment of simple lacerations in children is crucial in pediatric emergency departments.
  • Minimizing patient discomfort and procedural time is a key objective in pediatric care.
  • Topical anesthetics offer a potential non-invasive method to manage pain and expedite laceration treatment.

Purpose of the Study:

  • To evaluate the efficacy of topical local anesthetic application at triage in reducing total treatment time for pediatric simple lacerations.
  • To assess the impact of topical anesthesia on the need for additional sedation in children undergoing laceration repair.
  • To compare treatment durations between children receiving topical anesthetic and a placebo at triage.

Main Methods:

  • Prospective, randomized, double-blind, controlled trial in a pediatric emergency department.
  • Inclusion of children aged 1-10 years with simple lacerations, with specific exclusion criteria.
  • Randomization to either adrenaline, lignocaine (lidocaine), and amethocaine (ALA) or placebo at triage, with total treatment time as the primary outcome.

Main Results:

  • The ALA group (84 patients) had a median treatment time of 77 minutes, compared to 108 minutes for the control group (77 patients), a statistically significant reduction (P=.0019).
  • No significant difference in the requirement for sedation was observed between the ALA and control groups.
  • Wound closure methods included sutures, glue, Steristrips, or no formal closure across both groups.

Conclusions:

  • Topical anesthetic application at triage significantly decreases the total treatment time for pediatric simple lacerations.
  • This intervention is effective in streamlining emergency department workflows for minor wound care.
  • ALA provides a valuable tool for efficient and potentially less burdensome management of pediatric lacerations.
Abstract

More Related Videos

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow05:43

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

Related Concept Videos

Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...