Hung, 1997  Title: Comparative topical anaesthesia of EMLA
and liposome-encapsulated tetracaine.
Authors: Hung OR, Comeau L, Riley MR, Tan S,
Whynot S, Mezei M
Journal: Can J Anaesth 1997 Jul;44(7):707-11
PMID: 9232298, UI: 97376126
Affiliated institution: Department
of Anaesthesia, Dalhousie University, Halifax, Nova Scotia, Canada.
hungorla@is.dal.ca
Cited in:
BACKGROUND: The eutectic mixture of local anaesthetics (EMLA)
provides effective topical anaesthesia after a minimum of 60 to
90 min application. Since liposome-encapsulated tetracaine (LET)
can provide rapid dermal penetration, the goal of this study was
to compare the local anaesthetic effects of EMLA and LET in human
volunteers after 60 min application.
METHODS: After obtaining institutional approval and informed
consent, healthy volunteers were recruited in a double blind,
crossover, randomized trial. The study creams (0.5 ml EMLA and
0.5 ml LET 5%) were applied randomly to opposite arms for 60 min.
The discomfort of i.v. catheterization was assessed using a visual
analogue pain score (VAS). Cutaneous side effects of the creams
were recorded.
RESULTS: Sixty-one subjects were studied. Twenty-one were excluded
because of technical difficulties. Forty subjects completed the
study and were included in the data analysis. The mean ( +/- SD)
VAS was lower for LET than for EMLA (10.9 +/- 9.0 mm vs 22.7 +/-
17.1 mm, P < 0.001). Erythema secondary to vasodilatation occurred
more frequent in the LET group than in the EMLA group (33 vs 3,
P < 0.001). One subject with a history of atopy developed a
rash at the LET application site.
CONCLUSION: Liposome-encapsulated tetracaine can provide a more
effective topical anaesthesia than EMLA for intravenous catheterization
after 60 min application. Clinical evaluations are necessary to
determine the efficacy and safety of LET in providing topical
anaesthesia for various invasive percutaneous procedures in other
patient populations.
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