TOPICAL AGENTS
EMLA cream (lidocaine 2.5%
and prilocaine 2.5%) consists of a eutectic
mixture of local anesthetics. It is
used to provide topical anesthetic to intact skin. Other topical preparations
are effective only on mucosal sur-faces. EMLA has been shown to reduce pain on
venipuncture and provide substantial anesthesia for skin graft donor sites. No
significant local or systemic toxicity has been demonstrated.
TAC (tetracaine, adrenalin
[epinephrine], and co-caine) is a combination topical anesthetic frequently
used in pediatric emergency departments for repair of minor lacerations. The
usual mixture is tetracaine 0.5%, epinephrine 1:2,000, and cocaine 11.8%.
Because of po-tential complications (seizures), lower concentrations of cocaine
and epinephrine in a tetracaine 1% solution have been suggested (TAC III).
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