Randomized trial of novel tetracaine patch to provide local anaesthesia in neonates undergoing venepuncture

Procedures such as venepuncture or heel prick are painful and may cause considerable stress to newborn infants. Topical local anaesthetics are effective for venepuncture but need to be applied for at least 60 min and the delivered dose will vary. We assessed a novel tetracaine-based self-adhesive pa...

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Bibliographic Details
Published in:	British journal of anaesthesia : BJA Vol. 91; no. 4; pp. 514 - 518
Main Authors:	Long, C.P., McCafferty, D.F., Sittlington, N.M., Halliday, H.L., Woolfson, A.D., Jones, D.S.
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-10-2003 Oxford University Press Oxford Publishing Limited (England)
Subjects:	Administration, Cutaneous anaesthetics local anaesthetics local, tetracaine Anesthesia, Local - methods Anesthetics, Local - administration & dosage Anesthetics. Neuromuscular blocking agents Biological and medical sciences Double-Blind Method Female Humans Infant, Newborn Intraoperative Complications - prevention & control Male Medical sciences neonates Neuropharmacology pain Pain - prevention & control Pain Measurement - methods Pharmacology. Drug treatments Phlebotomy - methods tetracaine Tetracaine - administration & dosage veins veins, venepuncture venepuncture veins, venepuncture pain neonates anaesthetics local, tetracaine anaesthetics local, tetracaine; neonates; pain; veins, venepuncture Human anaesthetics local Percutaneous route Local anesthetic tetracaine; neonates; pain; veins Ester venepuncture Pain Newborn Local anesthesia Dosage form Puncture Vein Patch Tetracaine
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Summary:	Procedures such as venepuncture or heel prick are painful and may cause considerable stress to newborn infants. Topical local anaesthetics are effective for venepuncture but need to be applied for at least 60 min and the delivered dose will vary. We assessed a novel tetracaine-based self-adhesive patch in providing controlled local anaesthesia before venepuncture. A placebo-controlled, double-blind trial was conducted using a tetracaine patch formulated from hydroxypropylcellulose discs (0.283 cm2) containing tetracaine (1 mg cm−2) surrounded by a low tack pressure-sensitive adhesive backing layer. Thirty-two newborn infants of gestation 32–42 weeks (median 36 weeks), aged 3–18 days (median 6 days) were randomized to receive a tetracaine-containing patch or a placebo device applied to the dorsum of the hand 30 min before venepuncture to obtain blood samples. Pain was assessed in response to needle insertion using a validated adaptation of the neonatal facial coding score (NFCS) and the presence of crying. Of 15 tetracaine-treated neonates, 14 (93%) presented little or no pain in response to the procedure compared with six of 17 (35%) who had the placebo patch applied (P=0.01). The tetracaine patch produced effective pain relief during the venepuncture procedure in both term and pre-term infants. There were no adverse effects, either local or systemic.
Bibliography:	ark:/67375/HXZ-SR0BKM9H-L istex:72A3D59E01D27D18FE176E88945D2EC4B14694F9 Corresponding author. E‐mail: c.long@qub.ac.uk  †Deceased before completion of the study. local:aeg216 Accepted for publication: May 28, 2003 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0007-0912 1471-6771
DOI:	10.1093/bja/aeg216