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The Annals of Pharmacotherapy: Vol. 36, No. 4, pp. 687-692. DOI 10.1345/aph.1A138
© 2002 Harvey Whitney Books Company.
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Research Articles

Lidocaine-prilocaine cream versus tetracaine gel for procedural pain in children

A Taddio, MG Gurguis, and G Koren

OBJECTIVE: To determine the relative efficacy of lidocaine-prilocaine and tetracaine for procedural pain in children. METHODS: Systematic review was performed (MEDLINE1990-June 2001) of all studies comparing the efficacy of these 2 modalities of pain relief in children undergoing painful cutaneous procedures. Search terms included lidocaine, prilocaine, tetracaine, and anesthesia. RESULTS: Eight studies compared lidocaine-prilocaine with tetracaine in children for 4 different procedures: intravenous cannulation, venipuncture, Port-a-Cath puncture, and laser therapy. When used as labeled (60 min for lidocaine-prilocaine, 30 min for tetracaine), the 2 modalities provided similar analgesic efficacy. When both anesthetics were applied for a similar duration of time (40 min, 60 min, 2 h), tetracaine provided superior anesthesia. Tetracaine was commonly associated with erythema, and lidocaine-prilocaine was associated with blanching of the skin. CONCLUSIONS: Lidocaine-prilocaine and tetracaine appear to be comparable for procedural pain relief when used as recommended. Tetracaine is more efficacious than lidocaine-prilocaine when both anesthetics are applied for the same amount of time.


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