Schaffer D J
Ann Emerg Med. 1985 Nov;14(11):1077-80. doi: 10.1016/s0196-0644(85)80925-2.
Two preparations of a topical anesthetic solution were compared with regard to their relative effectiveness, the incidence of side effects, and the occurrence of wound infection. Solution A contained tetracaine 0.5%, adrenalin 1:2,000, and cocaine 11.8%; solution B contained the same amounts of tetracaine and adrenalin but no cocaine. Children less than 10 years old who presented with facial or scalp lacerations were randomized into the A and B groups. Solution A was significantly more effective (P = .01) in producing adequate anesthesia; 8.9% of these patients required supplemental xylocaine injection, compared with 27.5% of B patients. Clinical evidence of wound infection, manifested by erythema at the time of suture removal, occurred in 7% of group A patients; none of the group B patients showed these signs. Drowsiness or excitability following the use of solutions A and B occurred in 10.7% and 7.8%, respectively. There was no convincing evidence, however, that these were causally related, nor was there any statistical correlation. Because of the effectiveness of cocaine-based topical anesthetics in the pediatric population and the relatively low incidence of side effects, including wound infection, it is recommended that topical anesthesia for dermal laceration repair be considered as an alternative to injectable xylocaine.
对两种局部麻醉溶液制剂在相对有效性、副作用发生率和伤口感染发生率方面进行了比较。溶液A含有0.5%的丁卡因、1:2000的肾上腺素和11.8%的可卡因；溶液B含有相同量的丁卡因和肾上腺素，但不含可卡因。出现面部或头皮裂伤的10岁以下儿童被随机分为A组和B组。溶液A在产生充分麻醉方面显著更有效（P = 0.01）；这些患者中有8.9%需要补充注射利多卡因，而B组患者为27.5%。伤口感染的临床证据表现为拆线时的红斑，在A组患者中发生率为7%；B组患者均未出现这些迹象。使用溶液A和B后出现嗜睡或兴奋的情况分别发生在10.7%和7.8%的患者中。然而，没有令人信服的证据表明这些与因果关系有关，也没有任何统计学相关性。由于基于可卡因的局部麻醉剂在儿科人群中有效，且包括伤口感染在内的副作用发生率相对较低，建议将用于皮肤裂伤修复的局部麻醉作为注射用利多卡因的替代方法。
