TY - JOUR
T1 - A critical review of the topical local anesthetic amethocaine (Ametop™) for pediatric pain
AU - O'Brien, Lisa
AU - Taddio, Anna
AU - Lyszkiewicz, Dorothy A.
AU - Koren, Gideon
N1 - Funding Information:
No sources of funding were used to assist in the preparation of this review. The authors conducted a study on Ametop™ (O’Brien, 2004), supported by Smith and Nephew, Inc., Canada. Lisa O’Brien is supported by a studentship from the Ontario Student Opportunity Trust Fund – Hospital for Sick Children Foundation Student Scholarship Program. Anna Taddio and Gideon Koren are supported by the Canadian Institutes of Health Research. Gideon Koren is holder of the Ivey Chair in Molecular Toxicology, The University of Western Ontario.
PY - 2005
Y1 - 2005
N2 - A topical formulation of the ester-type local anesthetic amethocaine (tetracaine) [Ametop™] is currently available for reducing pain from cutaneous procedures such as venipuncture. The Ametop™ preparation contains 40mg of amethocaine base (4% w/w) and produces anesthesia within 30-45 minutes of application; duration of action ranges from 4 to 6 hours. Clinical studies have demonstrated the superiority of the 4% amethocaine preparation over placebo in pediatrie populations for indications such as intravenous cannulation, vaccination, and venipuncture. Amethocaine has been shown to produce anesthesia comparable to that of 5% lidocaine-prilocaine for procedures such as venipuncture and accessing centrally placed devices; in general, anesthesia was achieved more rapidly with amethocaine than lidocaine-prilocaine. In the neonatal population amethocaine was found to be ineffective at reducing the pain of heel prick and peripherally inserted central catheters. Depending on the type of procedure, amethocaine application times between 30 and 60 minutes have produced clinically acceptable anesthesia; application times <30 minutes have not been associated with reliable anesthesia. The 4% amethocaine preparation is well tolerated; the most commonly reported local skin reaction is transient local erythema while local edema and itching have been reported more rarely. There have been no accounts of systemic toxicity with topical use of the preparation. Several cases of sensitization have been described in adults upon repeated exposure to topical amethocaine. In summary, the novel preparation of 4% amethocaine gel has been shown to be clinically effective for managing pain associated with minor cutaneous procedures while maintaining a good tolerability profile. Amethocaine has also demonstrated similar efficacy to lidocaine-prilocaine when appropriate application times are used; the more rapid onset of action and extended duration of action of amethocaine may make it more useful than lidocaine-prilocaine in busy clinical settings.
AB - A topical formulation of the ester-type local anesthetic amethocaine (tetracaine) [Ametop™] is currently available for reducing pain from cutaneous procedures such as venipuncture. The Ametop™ preparation contains 40mg of amethocaine base (4% w/w) and produces anesthesia within 30-45 minutes of application; duration of action ranges from 4 to 6 hours. Clinical studies have demonstrated the superiority of the 4% amethocaine preparation over placebo in pediatrie populations for indications such as intravenous cannulation, vaccination, and venipuncture. Amethocaine has been shown to produce anesthesia comparable to that of 5% lidocaine-prilocaine for procedures such as venipuncture and accessing centrally placed devices; in general, anesthesia was achieved more rapidly with amethocaine than lidocaine-prilocaine. In the neonatal population amethocaine was found to be ineffective at reducing the pain of heel prick and peripherally inserted central catheters. Depending on the type of procedure, amethocaine application times between 30 and 60 minutes have produced clinically acceptable anesthesia; application times <30 minutes have not been associated with reliable anesthesia. The 4% amethocaine preparation is well tolerated; the most commonly reported local skin reaction is transient local erythema while local edema and itching have been reported more rarely. There have been no accounts of systemic toxicity with topical use of the preparation. Several cases of sensitization have been described in adults upon repeated exposure to topical amethocaine. In summary, the novel preparation of 4% amethocaine gel has been shown to be clinically effective for managing pain associated with minor cutaneous procedures while maintaining a good tolerability profile. Amethocaine has also demonstrated similar efficacy to lidocaine-prilocaine when appropriate application times are used; the more rapid onset of action and extended duration of action of amethocaine may make it more useful than lidocaine-prilocaine in busy clinical settings.
UR - http://www.scopus.com/inward/record.url?scp=15944378534&partnerID=8YFLogxK
U2 - 10.2165/00148581-200507010-00004
DO - 10.2165/00148581-200507010-00004
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.systematicreview???
C2 - 15777110
AN - SCOPUS:15944378534
SN - 1174-5878
VL - 7
SP - 41
EP - 54
JO - Paediatric Drugs
JF - Paediatric Drugs
IS - 1
ER -