Heated lidocaine/tetracaine patch (Synera™, Rapydan™) compared with lidocaine/prilocaine cream (EMLA®) for topical anaesthesia before vascular access
Open Access
- 1 February 2009
- journal article
- research article
- Published by Elsevier BV in British Journal of Anaesthesia
- Vol. 102 (2), 210-215
- https://doi.org/10.1093/bja/aen364
Abstract
We compared the lidocaine/tetracaine patch [Synera™ (USA), Rapydan™ (Europe)], a novel heat-aided patch using a eutectic mixture of lidocaine 70 mg and tetracaine 70 mg, with a eutectic mixture of lidocaine 25 mg ml−1 and prilocaine 25 mg ml−1 (EMLA® Cream). The agents were administered at different time periods for local topical anaesthesia before a vascular access procedure. In this double-blind, paired study, 82 adult volunteers were randomized to receive the lidocaine/tetracaine patch on one anticubital surface and lidocaine/prilocaine cream on the other concurrently for 10, 20, 30, or 60 min before a vascular access procedure. Subjects rated pain intensity using a 100 mm visual analogue scale (VAS). Skin reactions and adverse events were also evaluated. Median VAS scores were significantly lower for the lidocaine/tetracaine patch than for lidocaine/prilocaine cream in the 10 min (P=0.010), 20 min (P=0.042), and 30 min (P=0.001) application groups. The lidocaine/tetracaine patch was associated with significantly more erythema than lidocaine/prilocaine cream at 20, 30, and 60 min, whereas lidocaine/prilocaine cream produced more blanching than the lidocaine/tetracaine patch at 30 and 60 min. Two subjects reported nausea and faintness associated with the vascular access procedure; one was withdrawn from the study. The lidocaine/tetracaine patch provided effective anaesthesia with an application time as short as 10 min and was better than lidocaine/prilocaine cream at all application times shorter than 60 min, demonstrating a substantial improvement in time to onset of anaesthesia. The lidocaine/tetracaine patch provided an important alternative to lidocaine/prilocaine cream for topical local anaesthesia.Keywords
This publication has 10 references indexed in Scilit:
- Use of the Synera™ Patch for Local Anesthesia Before Vascular Access Procedures: A Randomized, Double-Blind, Placebo-Controlled StudyPain Medicine, 2007
- Topical Anesthetics for Dermal Instrumentation: A Systematic Review of Randomized, Controlled TrialsAnnals of Emergency Medicine, 2005
- Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Lidocaine/Tetracaine Patch for Induction of Local Anesthesia prior to Minor Dermatologic Procedures in Geriatric PatientsDermatologic Surgery, 2005
- A Randomized Controlled Trial to Evaluate S-Caine Patch™ for Reducing Pain Associated with Vascular Access in ChildrenAnesthesiology, 2005
- Topical AnestheticsAmerican Journal of Drug Delivery, 2004
- Lidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosaJournal of the American Academy of Dermatology, 2001
- Evaluating Skin Anesthesia After Administration of a Local Anesthetic System Consisting of an S-Caine™ Patch and a Controlled Heat-Aided Drug Delivery (CHADD™) Patch in VolunteersThe Clinical Journal of Pain, 2000
- Topical amethocaine (Ametop™) is superior to EMLA for intravenous cannulationCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1999
- Comparative topical anaesthesia of EMLA and liposome-encapsulated tetracaineCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1997
- Studies with different types of visual analog scales for measurement of painCancer Cell, 1983