NDLI: Injectable lidocaine provides similar analgesia compared to transdermal lidocaine/tetracaine patch for the incision and drainage of skin abscesses: a randomized, controlled trial.

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Injectable lidocaine provides similar analgesia compared to transdermal lidocaine/tetracaine patch for the incision and drainage of skin abscesses: a randomized, controlled trial.

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Injectable lidocaine provides similar analgesia compared to transdermal lidocaine/tetracaine patch for the incision and drainage of skin abscesses: a randomized, controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bourne, Christina L. Brewer, Kori L. House, Joseph
Description	Author Affiliation: Bourne CL ( Division of Emergency Medicine, Medical University of South Carolina, Charleston, South Carolina.); Brewer KL ( Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina.); House J ( Department of Emergency Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan.)
Abstract	BACKGROUND: Local anesthesia used for incision and drainage of abscesses is known to be painful. STUDY OBJECTIVE: We studied the analgesia provided by a lidocaine/tetracaine patch compared to injectable lidocaine during incision and drainage (I&D) of skin abscesses. METHODS: This was a prospective, double-blind, randomized, controlled trial carried out in the Emergency Department (ED) of an adult tertiary referral center. Adult patients with a skin abscess in need of I&D were randomized to one of two groups. One group received a lidocaine/tetracaine patch and injectable normal saline for anesthesia. The second group received a placebo patch and injectable 1% lidocaine. A visual analog pain scale was used to record the patient's pain level prior to treatment, during the procedure, and after I&D. RESULTS: There were 20 patients enrolled in the study, including 12 randomized to the lidocaine/tetracaine patch and 8 to the injectable lidocaine. Pain scores preprocedure were similar in the two groups. Pain scores during I&D and postprocedure were compared between groups using a paired t-test. Patients receiving injectable lidocaine experienced pain that was similar (50.1 ± 5.9 mm; 95% confidence interval [CI] 45.2-55.1) to those receiving the transdermal lidocaine/tetracaine patch (60.1 mm ± 11.0; 95% CI = 55.2-68.1), p = 0.04, with a power of 80% to detect a difference of 20 mm at p ≤ 0.05; although this was statistically significant, it was not clinically significant. There was also no statistical difference between the two groups in the postprocedure pain scores (p = 0.65). CONCLUSION: Local injection of lidocaine provided clinically similar analgesia compared to the lidocaine/tetracaine patch during I&D of skin abscesses in the ED. Pain at presentation and after the procedure was similar in both groups. Emergency physicians should continue to use a local injected anesthetic for I&D of skin abscesses until a less painful alternative is identified.
File Format	HTM / HTML
ISSN	07364679
Issue Number	3
Volume Number	47
Journal	The Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2014-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency medicine Abscess Surgery Anesthesia, Local Methods Lidocaine Administration & Dosage Pain Drug Therapy Tetracaine Adolescent Adult Anesthetics, Local Double-blind Method Female Humans Injections, Intradermal Male Middle Aged Pain Management Prospective Studies Transdermal Patch Young Adult Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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Injectable lidocaine provides similar analgesia compared to transdermal lidocaine/tetracaine patch for the incision and drainage of skin abscesses: a randomized, controlled trial.