Topical anaesthesia for children's lacerations: an acceptable approach?

Area of Science:

• Pediatric Emergency Medicine
• Anesthesiology
• Wound Management

Background:

• Laceration repair in children often requires local anesthesia.
• Pain associated with local anesthetic administration can be a significant challenge.
• Conventional intradermal lignocaine may cause considerable pain in pediatric patients.

Purpose of the Study:

• To compare the anesthetic efficacy of topical adrenaline and cocaine (AC) gel versus conventional intradermal lignocaine.
• To evaluate pain perception during local anesthetic administration and wound suturing in children.
• To assess the acceptability of each anesthetic method for parents and children.

Main Methods:

• A randomized study involving children aged 3-16 years with lacerations.
• Participants received either topical AC gel or intradermal lignocaine.
• Pain scores were assessed using Wong Baker faces and visual analogue scales by patients, parents, and staff.

Main Results:

• The AC group experienced significantly lower pain scores during anesthetic administration compared to the lignocaine group (P < 0.001).
• No significant difference in pain scores was observed during wound suturing between the groups.
• The AC anesthetic was rated as acceptable by a higher percentage of parents (84.5%) than lignocaine (61%) (P < 0.01).

Conclusions:

• Topical adrenaline and cocaine (AC) gel is a superior local anesthetic for pediatric lacerations compared to lignocaine.
• AC gel offers better pain control during anesthetic administration and higher parental acceptance.
• AC gel should be considered the first-choice anesthetic for appropriate pediatric laceration repairs.