| Pryor GJ et al, 1980, USA | 158 patients presenting to the emergency department with minor lacerations. Topical TAC versus lidocaine infiltration for anaesthesia | PRCT | Acceptability of application of anaesthetic | TAC was thought to be more acceptable in children under 17 yrs (p<0.0001), no significant difference in adults | Few baseline data about patient group. Some data presented in graph form or percentage values only with significance mentioned in accompanying text |
| | | Efficacy of anaesthesia in patients over 10 yrs | In 10–17 yrs old patients TAC was effective in 82% and lidocaine in 83% (p = 1). In patients over 17 yrs TAC was effective in 86% and lidocaine in 92% (p = 0.25) | |
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| | | Time taken to repair wound | Significantly reduced in children under 5 yrs (p<0.005) | |
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| Anderson AB et al, 1990, USA | 151 children under 18 yrs presenting to the emergency department with skin lacerations less than 5 cm | PRCT | Initial anaesthesia (tested by pinprick) | TAC 89%; lidocaine 79%; placebo 17% (TAC v placebo p<0.0001; lidocaine v placebo p<0.0001) | Method of randomisation not clear from text. One error noted in results table. Some data only given in chart form |
| Intradermal lidocaine versus topical TAC versus topical placebo (adrenaline plus normal saline) | | Patients requiring additional lidocaine infiltration | TAC 18%; lidocaine 23%; placebo 60%; (TAC v placebo p<0.0001; lidocaine v placebo p<0.0005) | |
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| | | Complete patient compliance—assessed by physician | TAC 80%; lidocaine 49%; placebo 43% (TAC significantly better than either lidocaine or placebo p<0.002) | |
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| Hegenbarth MA et al, 1990, USA | 467 patients aged 18 yrs or younger presenting to an emergency department with minor lacerations requiring suturing. Wounds classified as head/scalp or trunk/extremity then randomised to either topical TAC or lidocaine infiltration | PRCT | Adequacy of anaesthesia for scalp/head wounds | TAC adequate in 80.7%; lidocaine adequate in 86.6% (p = 0.159) | Randomised by case-note number. Error in p value for adequacy of anaesthesia for scalp/head wounds. Only 68% of patients followed up when looking at wound infection rates though dropout rate similar in each group (68% of TAC patients, 66% of lidocaine patients reviewed) |
| | | Adequacy of anaesthesia for extremity/trunk wounds | TAC adequate in 43.2%, lidocaine adequate in 89.4% (p<0.0001) | |
| | | Infection rates | 2.2% for both TAC and lidocaine groups | |
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| Smith GA, et al, 1996, USA | 240 patients over 2 yrs old presenting to the emergency department with a skin laceration 5 cm or less that required suturing | Partially blinded PRCT | Anaesthesia by pain score by patients, parents, suture technicians and research assistant observers | No significant difference between TAC, bupivacaine with NA and lidocaine infiltration. All other agents less effective | The method of randomisation is described as block randomisation but there are 60 patients in both the lidocaine and TAC groups with 30 patients in each of the other groups. It is mentioned in the results area that some patients required supplemental lidocaine infiltration but it does not say who was or how this affected the outcome. Raw data are not provided, only the statistical methods and results of significance |
| Bupivacaine with NA v etidocaine with NA v mepivacaine with NA v prilocaine with NA v TAC v lidocaine infiltration | | | | |
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| Kendall JM et al, 1996, UK | 107 children between 3 and 16 yrs presenting to the emergency department with wounds less than 4 cm requiring suturing | PRCT | Pain score on application of anaesthetic | Infiltration of lidocaine significantly more painful than application of TAC (p<0.001) | No mention of wound site. No breakdown of different age groups of children |
| | | Pain score on wound closure | No significant difference between lidocaine and TAC | |
| | | Acceptability of procedure | 14.5% of parents found procedure with AC gel “stressful” or “unacceptable” compared with 39% of parents when lidocaine was used | |
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| Ernst AA et al, 1997, USA | 66 patients aged 5 yrs or over with lacerations <10 cm | PRCT | Pain of anaesthetic application | LAT gel significantly less painful than lidocaine injection (p<0.001)(Mean VAS by physician for LAT = 0 and lidocaine = 1.4. Mean VAS by patient for LAT = 0, lidocaine = 1.2) | Small study. Data in figures poorly labelled |
| Topical LAT gel v injectable buffered lidocaine with adrenaline | | Pain of suturing | No significant difference between lidocaine and LAT gel. (Physician p = 0.83; patient p = 0.48) | |
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| Smith GA et al, 1997, USA | 71 patients 2 yrs or over presenting to the emergency department with a laceration on the face or scalp less than 5 cm that required suturing | PRCT | Effective anaesthesia judged by VAS by suture technician and research assistant | No significant difference between effect of TAC and lidocaine infiltration Mepivacaine less effective (p = 0.003 and 0.0003, respectively) | Small numbers. Results provided in graph form |
| Topical TAC v topical mepivacaine and NA v lidocaine infiltration | | | | |