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Topical analgesics decreased pain of tissue adhesive repairs
Using a topical analgesic before wound closure with tissue adhesive in children reduced ratings of pain and increased pain free repairs, according to recent study findings published in the Canadian Medical Association Journal.
“Perhaps the most meaningful outcome for parents and children facing acute pain in the emergency department is how likely a procedure is going to be completely pain free,” Stuart Harman, MD, of the Children’s Hospital of Eastern Ontario, and colleagues wrote. “More than half of the patients who received lidocaine-epinephrine-tetracaine in our study (or their parents or guardians) reported no pain during adhesive application, which was nearly double the proportion of pain-free procedures reported in the placebo group.”
Stuart Harman
The randomized, placebo-controlled study included 221 children aged 3 months to 17 years who presented to a tertiary-care pediatric ED needing wound closure between March 2011 and January 2012. One group received a topical analgesic (lidocaine-epinephrine-tetracaine) and the other received a placebo.
Using the Faces Pain Scale – Revised, researchers found that 51.6% of participants in the intervention group reported pain-free procedures compared with 28.3% in the placebo group (RR=0.54; 95% CI, 0.37-0.80). Wound homeostasis, as rated by physicians, was 78.2% in the treatment group and 59.3% in the placebo group.
“Pretreatment of minor lacerations with lidocaine-epinephrine-tretracaine before tissue repair with adhesive decreased patient discomfort and increased the proportion of pain-free repairs,” researchers wrote. “Routine use of this simple and low-risk intervention as soon as the need for wound repair is identified may improve the experience of children undergoing treatment of lacerations.”
Stuart Harman, MD can be reached at sharman@cheo.on.ca.
Disclosure: The study was funded in part by the Children’s Hospital of Eastern Ontario Research Institute.
