Local anesthesia in minor lacerations: topical TAC vs lidocaine infiltration

To evaluate a solution of tetracaine (0.5%), adrenaline 1:2,000, and cocaine (11.8%) as a topical anesthetic in the repair of minor lacerations, a prospective randomized study was performed comparing it with lidocaine infiltration. One hundred fifty-eight patients of a primarily pediatric age group were treated in the emergency department of Madigan Army Medical Center. Anesthetic efficacy was subjectively evaluated. Other variables observed were patient/parent acceptance of the anesthesia, time required for surgical repair, and wound complication rates. No significant difference was found in the anesthetic efficacy of topical TAC and lidocaine infiltration. Time for surgical repair was significantly reduced, and patient acceptance of topical TAC was markedly improved over lidocaine infiltration. Wound complication rates were not significantly different. This form of anesthesia has definite benefits for the emergency physician because it results in a more manageable patient, with subsequent reduction in physician time required to treat minor lacerations in pediatric patients.