The pain of tissue adhesive, an alternative to stitches, may be eliminated or reduced with a pain-relieving gel, according to a study of pediatric emergency room visits in Ottawa.
Tissue adhesive or "skin glue" is often used to repair minor cuts in children but it can cause pain or a burning sensation, previous research suggests.
Parents and children going to an emergency department could be concerned with how likely a procedure is to be completely pain free. (iStock) When researchers randomly assigned children receiving the adhesive for minor cuts to receive a topical analgesic or a placebo, they found the proportion of pain-free repairs increased with the analgesic.
"Perhaps the most meaningful outcome for parents and children facing acute pain in the emergency department is how likely a procedure is to be completely pain free," Dr. Stuart Harman, of the emergency medicine division at the University of Ottawa and his co-authors concluded in Monday's issue of the Canadian Medical Association Journal.
"More than half of the patients who received lidocaine–epinephrine–tetracaine in our study (or their parents or guardians) reported no pain during adhesive application, which was nearly double the proportion of pain-free procedures reported in the placebo group," they reported.
The analysis included 105 children aged three months to 17 years who were given lidocaine–epinephrine–tetracaine and 98 children in the placebo group. Their lacerations were less than 3 centimetres in length on the face, torso, trunk or extremities that the treating physician considered appropriate to repair with tissue adhesive.
Between March 2011 and January 2012, nurses administered the active drug or placebo gel from identical opaque elevators containing syringes prepared by pharmacy staff. After it was left on for at least 45 minutes, a doctor removed the gel when repairing the wound. The repair occurred at most 120 minutes after application.
On one scale, nearly 52 per cent of children receiving the analgesic reported "no pain" compared with 28 per cent in the other group.
The study's authors said pharmacy staff prepare the analgesic syringes from raw materials in-house at a cost of $1.58 per dose, including the cost of the syringe. The gel needs to be applied for at least 20 minutes to work but it can be done while the patient is waiting for the doctor.
The research was funded by the Children's Hospital of Eastern Ontario Research Foundation.
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