Prospective Evaluation of Topical Analgesia for Laceration Repair in the Emergency Department
Prospective Evaluation of Topical Analgesia Using a Lidocaine/Prilocaine Cream for Laceration Repair in the Emergency Department
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
A prospective randomized open clinical trial conducted in two high volume emergency departments in France.
Adult patients presenting for laceration repair by suture will be allocated, after consent is obtained, on a one to one basis using a randomisation by minimisation method.
126 patients are expected to enrol in the study.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Angers, France, 49 000
- Centre Hospitalier Universitaire Angers
-
Le Mans, France, 72 000
- Centre Hospitalier Le Mans
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Superficial skin laceration requiring a suture
Exclusion Criteria:
- Known allergy to lidocaine
- Mucous membrane or eye wound
- Nose, ear or perineal wound
- Active hemorrhage in the wound
- Dirty or infected wound
- Wound requiring operation room management
- Distracting pain in an other location
- Intoxicated or comatose patient
- Patient Under guardianship
- Contra-indication to Lidocaine/Prilocaine cream: hypersensitivity, glucose-6-phosphate deficiency, idiopathic methemoglobinemia
- Neurologic disorder affecting pain sensitivity
- Dementia
- Pregnancy, breast feeding, absence of contraceptive measures for women of childbearing age
- Absence of signed informed consent
- Inclusion in an other interventional clinical protocol
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Topical anesthesia
Topical anesthesia using a cream containing 2.5% Lidocaine and 2.5% Prilocaine applied for at least 30 minutes before laceration repair.
|
Topical anesthesia using a cream containing 2.5% Lidocaine and 2.5 % Prilocaine for at least 30 minutes on and around the wound before suture
|
|
Experimental: Subcutaneous injection anesthesia
Local anesthesia by a subcutaneous injection of a solution containing 1% Lidocaine and 0.005 mg/mL Epinephrine in the minutes before laceration repair.
|
Local anesthesia by subcutaneous injection of a solution containing 1% Lidocaine and 0.005mg/mL Epinephrine in and around the wound in the minutes preceding the suture of the wound
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Maximum pain
Time Frame: 60 minutes
|
Maximum pain on the numerical pain scale (0-10) during laceration management (anesthesia, exploration and suture of the laceration).
|
60 minutes
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient satisfaction
Time Frame: 60 minutes
|
Patient satisfaction relating to the pain management measured on a four point Likert scale.
|
60 minutes
|
|
Topical anesthesia failure rate
Time Frame: 60 minutes
|
Percentage of patients in the intervention group who required additional anesthesia by subcutaneous injection of Lidocaine/Epinephrine
|
60 minutes
|
|
Pain management during the various stages of care
Time Frame: 60 minutes
|
Maximum pain measured on the numerical pain scale (0-10) measured on admission to the emergency department, during the wait for laceration treatment, during the wound cleansing for the intervention group and during anesthesia for the control group, during suture.
|
60 minutes
|
|
Management duration
Time Frame: 60 minutes
|
Mean duration of management between admission to the emergency department and discharge.
|
60 minutes
|
|
Adverse effects
Time Frame: 15 days
|
Evaluation of adverse effects due to the anesthesia technique (e.g.
allergic reactions) by a telephone interview 15 days after initial management
|
15 days
|
|
Wound healing
Time Frame: 15 days
|
Evaluation of the quality of wound healing during a telephone interview by identifying signs of wound infection and/or wound reopening.
|
15 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Julien Fonsegrive, MD, Centre Hospitalier Le Mans
Publications and helpful links
General Publications
- McNulty RJ, Handley TP, Devlin MF. Reducing the need for general anaesthesia in children: use of LAT gel in treating facial lacerations. Br J Oral Maxillofac Surg. 2013 Sep;51(6):e130-1. doi: 10.1016/j.bjoms.2012.04.259. Epub 2012 Jun 12.
- White NJ, Kim MK, Brousseau DC, Bergholte J, Hennes H. The anesthetic effectiveness of lidocaine-adrenaline-tetracaine gel on finger lacerations. Pediatr Emerg Care. 2004 Dec;20(12):812-5. doi: 10.1097/01.pec.0000148029.61222.9f.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Pain
- Neurologic Manifestations
- Wounds and Injuries
- Disease Attributes
- Emergencies
- Acute Pain
- Lacerations
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Anti-Arrhythmia Agents
- Central Nervous System Depressants
- Autonomic Agents
- Peripheral Nervous System Agents
- Sensory System Agents
- Anesthetics
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Membrane Transport Modulators
- Anesthetics, Local
- Voltage-Gated Sodium Channel Blockers
- Sodium Channel Blockers
- Bronchodilator Agents
- Anti-Asthmatic Agents
- Respiratory System Agents
- Adrenergic beta-Agonists
- Sympathomimetics
- Anesthetics, Combined
- Vasoconstrictor Agents
- Mydriatics
- Lidocaine
- Prilocaine
- Lidocaine, Prilocaine Drug Combination
- Epinephrine
Other Study ID Numbers
Other Study ID Numbers
- CHM-2016-S2/04
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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