Pain Experience Using Lidocaine Adrenaline Tetracaine (LAT) Gel Versus Lidocaine Infiltration for Laceration Repair in Adults

Pain Experience Using Lidocaine Adrenaline Tetracaine (LAT) Gel Versus Lidocaine Infiltration for Laceration Repair in Adults: a Prospective Comparative Study in the Emergency Department

This prospective comparative study evaluates pain experience in adult patients undergoing laceration repair in the emergency department using either topical lidocaine-adrenaline-tetracaine (LAT) gel or lidocaine infiltration as local anaesthesia. Lidocaine infiltration is the standard anaesthetic technique for wound repair but can cause significant pain during injection. LAT gel is a needle-free topical anaesthetic that is widely used in paediatric patients but has been less studied in adults.

Adult patients presenting with simple lacerations requiring suturing are allocated to receive either LAT gel or lidocaine infiltration according to the clinical judgement of the treating physician. Pain is measured using a visual analogue scale (VAS) during anaesthetic administration, during testing of anaesthetic effectiveness, and during suturing. Additional variables include wound characteristics, patient characteristics, and the need for additional anaesthesia. The study aims to evaluate whether LAT gel provides comparable pain control while reducing pain during anaesthetic administration.

Study Overview

• Status: Completed
• Conditions: Lacerations; Pain Management; Wound Repair; Acute Traumatic Wounds
• Intervention / Treatment: Drug: Lidocaine-Adrenaline-Tetracaine (LAT) Gel; Drug: Lidocaine infiltration

Detailed Description

Pain management is an important component of wound treatment in the emergency department. Local anaesthesia is routinely required for laceration repair, most commonly using infiltrative anaesthesia with lidocaine. Although effective, lidocaine infiltration can cause significant discomfort due to the injection itself and may increase patient anxiety. In addition, infiltration can sometimes distort tissue and potentially complicate the suturing procedure. Alternative approaches that reduce pain during anaesthetic administration may therefore improve patient comfort during wound management.

Topical anaesthesia using lidocaine-adrenaline-tetracaine (LAT) gel represents a needle-free alternative to infiltrative anaesthesia. LAT gel is commonly used in paediatric patients and has demonstrated effectiveness in reducing pain during laceration repair. However, evidence regarding its use in adult patients remains limited. Evaluating the effectiveness of LAT gel in adults may help determine whether it can be used more broadly as an alternative to injection-based anaesthesia in the emergency department.

This prospective comparative study includes adult patients presenting to the emergency department of Universitair Ziekenhuis Brussel with simple lacerations requiring suturing. Patients receive either LAT gel or lidocaine infiltration as local anaesthesia according to the clinical judgement of the attending physician. Pain experience is measured using a visual analogue scale (VAS) during anaesthetic administration, during testing of anaesthetic adequacy, and during suturing. Additional variables recorded include patient characteristics, wound characteristics, suturing characteristics, the need for additional anaesthesia, and procedure-related complications. The aim of the study is to compare pain experience between both anaesthetic techniques and to assess whether LAT gel may represent a suitable alternative for selected adult lacerations.

• Study Type: Interventional
• Enrollment (Actual): 70
• Phase: Phase 4

Contacts and Locations

Study Locations

• Belgium
  • Brussels Capital
    • Jette, Brussels Capital, Belgium, 1090
      • Department of Emergency Medicine, Universitair Ziekenhuis Brussel, and Research Group on Emergency and Disaster Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 18 years
• Presentation to the emergency department with a simple laceration requiring suturing
• Laceration length less than 7 cm
• Ability to provide informed consent
• Ability to report pain using a visual analogue scale (VAS)

Exclusion Criteria:

• Suspected tendon injury or nerve injury
• Wounds located on mucosal surfaces
• Wounds located on ears, nose, or genital area
• Known allergy to local anaesthetic agents
• Pregnancy
• Severe cardiac or pulmonary disease
• Drug intoxication or altered mental status
• Sedation with nitrous oxide
• Psychiatric disorder interfering with pain reporting
• Language barrier preventing informed consent or pain assessment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: LAT Gel; Patients receive topical lidocaine-adrenaline-tetracaine (LAT) gel applied directly into the wound prior to suturing.	Drug: Lidocaine-Adrenaline-Tetracaine (LAT) Gel; LAT gel (lidocaine 4%, adrenaline 0.1%, tetracaine 0.5%) is applied directly into the wound at a dose of approximately 0.5 mL per centimetre of wound length and covered with an occlusive dressing for 30 minutes prior to suturing.
Active Comparator: Lidocaine Infiltration; Patients receive infiltrative local anaesthesia prior to suturing.	Drug: Lidocaine infiltration; Subcutaneous infiltration of lidocaine 1% is administered locally around the wound approximately 5 minutes prior to suturing.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain during suturing	Pain experienced during wound suturing measured using a 100 mm visual analogue scale (VAS).	During suturing procedure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain during anaesthetic administration	Pain experienced during administration of the anaesthetic (LAT gel application or lidocaine infiltration) measured using a visual analogue scale (VAS).	At time of anaesthetic administration
Pain during testing of anaesthetic effectiveness	Pain experienced during testing of anaesthetic adequacy using a needle prick, measured using a visual analogue scale (VAS).	After waiting period for anaesthesia (30 minutes LAT gel / 5 minutes lidocaine)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Need for additional anaesthesia	Number of patients requiring additional lidocaine infiltration due to insufficient anaesthetic effect.	During wound preparation prior to suturing
Wound characteristics	Description of wound location and wound length.	At time of emergency department presentation

Collaborators and Investigators

• Sponsor: Vrije Universiteit Brussel
• Collaborators: Universitair Ziekenhuis Brussel

Publications and helpful links

General Publications

• Adler AJ, Dubinisky I, Eisen J. Does the use of topical lidocaine, epinephrine, and tetracaine solution provide sufficient anesthesia for laceration repair? Acad Emerg Med. 1998;5(2):108-12.
• Vandamme E, Lemoyne S, van der Gucht A, de Cock P, van de Voorde P. LAT gel for laceration repair in the emergency department: not only for children? Eur J Emerg Med. 2017;24(1):55-9.
• Ernst AA, Marvez-Valls E, Nick TG, Mills T, Minvielle L, Houry D. Topical lidocaine adrenaline tetracaine (LAT gel) versus injectable buffered lidocaine for local anesthesia in laceration repair. West J Med. 1997;167(2):79-81.

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2021
• Primary Completion (Actual): May 22, 2021
• Study Completion (Actual): May 31, 2021

Study Registration Dates

• First Submitted: March 14, 2026
• First Submitted That Met QC Criteria: March 14, 2026
• First Posted (Actual): March 18, 2026

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 14, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Emergency department; Pain measurement; Laceration repair; Local anaesthesia; Topical anaesthesia; Lidocaine infiltration; LAT gel; Adult trauma
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Pathologic Processes; Disease Attributes; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Emergencies; Wounds and Injuries; Agnosia; Lacerations; Pharmaceutical Preparations; Dosage Forms; Complex Mixtures; Colloids; Gels
• Other Study ID Numbers: EC-2020-146

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data that underlie the results reported in this study, after de-identification, may be shared upon reasonable request. Shared data may include demographic characteristics, wound characteristics, treatment allocation, and pain scores measured using the visual analogue scale (VAS).
• IPD Sharing Time Frame: Data will be available beginning 6 months following publication of the study results and will remain available for up to 5 years after publication.
• IPD Sharing Access Criteria: Data will be available to researchers who provide a methodologically sound proposal for secondary analyses. Proposals should be directed to the corresponding author. Access will be granted after review and approval by the study investigators and the institutional review board when required. Data will be shared in a de-identified format in accordance with institutional and data protection regulations.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No