• Anna Taddio, Mona G Y Gurguis, and Gideon Koren.
• Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada.
• Ann Pharmacother. 2002 Apr 1;36(4):687-92.

ObjectiveTo determine the relative efficacy of lidocaine-prilocaine and tetracaine for procedural pain in children.MethodsSystematic 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.ResultsEight 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.ConclusionsLidocaine-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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