Use of topical local anaesthetics for paediatric facial lacerations

Closure of facial lacerations in young children can be difficult under local anaesthetic in an emergency department setting. Sedation or general anaesthetic are often required to close lacerations safely and to a good surgical standard. Our hospital introduced the use of local anaesthetic gel (LAT) following an audit, to reduce the need for paediatric admissions. In light of the current COVID-19 pandemic, this can be a valuable tool to help avoid admissions.

To ascertain the usefulness of LAT gel in reducing paediatric admissions.

Data was collected prospectively of all children presenting to the paediatric emergency department for input by the oral and maxillofacial team after the introduction of LAT gel. Data collected included age, aetiology, length and position of laceration, associated injuries and management. Use of LAT gel and other anaesthetics was recorded.

Over a 12 month period, 536 children attended the paediatric ED. Paediatric lacerations accounted for 45% of the reasons for attendance. LAT gel was used in management of 33% of patients with facial lacerations. The use of the gel was successful in 76% of occasions. Ninety children (16.8% of all attendances) were admitted to hospital during this time, of which 49 were paediatric lacerations.

LAT gel is an effective adjunct to management of laceration in the paediatric population.