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- $Unique_ID{BRK01435}
- $Pretitle{}
- $Title{New Anesthetic Technique For Open Cuts}
- $Subject{laceration repair localized anesthetics special procedures skin cut
- subcutaneous tissue anesthetic cuts local anesthetic solution soak numb pain
- topical tac tetracaine adrenaline cocaine lidocaine injection lacerations
- procedure solutions soaking numbing}
- $Volume{P-20, L-20}
- $Log{}
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- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- New Anesthetic Technique For Open Cuts
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- QUESTION: When I took my youngster to the emergency room for some stitches in
- an open cut on the arm, I was permitted to stay in the room during the repair,
- as I worked as a nurse before my marriage. However I was a bit surprised at
- the physician's technique, which did not use the injection of a local
- anesthetic before the sutures, but rather a soak with some solution to numb
- the pain. I guess I should have asked about it when I was there, but I
- didn't, and wonder if you can explain what this technique is all about. It
- certainly seemed to work fine. Thank you.
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- ANSWER: There is no stopping progress and this technique does seem to be the
- answer to a mother's (and physician's) prayer when a youngster must be treated
- for an open laceration. It consists of soaking the open wound with a topical
- solution called TAC which is made up of 0.5 percent tetracaine, 1:2000
- adrenaline, and 11.8 percent cocaine. It is considered to be as effective a
- pain killer as the traditional lidocaine injection, but does away with the
- need of additional needle sticks for an already frightened child. This
- permits the physician to establish a calming and soothing relationship with
- the young patient, without proving any new additional pain that can often
- destroy any confidence at the very outset of an emergency visit. The trick in
- using this technique is to use sterile cotton balls saturated with TAC (rather
- than gauze pads) which allow the liquid to penetrate into the wound. The dose
- is 1 ml of solution for every 1 cm of laceration with a maximum of 10 ml. The
- parent can be of valuable assistance and help to hold the soaked cotton balls
- on the wound (while wearing rubber gloves to prevent numbing the hand as
- well!) for about ten minutes. Cleaning a wound prepared in this manner is
- easier, and the surgical repair is swifter, as the edges of the wound have not
- been altered, as may happen in the case of an injection. Most important of
- all is that the child may exit the procedure with more smiles than tears, and
- reduced anxiety if this frequent childhood emergency recurs at another time.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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