Topical Anesthesia Use in Children

Kimberly A. Pesaturo, PharmD, BCPS; Michele Matthews, PharmD


US Pharmacist. 2009;34(3):HS-4- HS-7. 

In This Article

Heat-Enhanced Drug-Delivery Systems

With their ease of application, patches are another method of topical anesthesia that is favored for use in children. One novel product consists of a eutectic mixture of lidocaine 70 mg and tetracaine 70 mg (Synera). This patch is a disposable, oxygen-activated system that uses heat to enhance drug absorption through the stratum corneum.[14] It was originally marketed without the heating element under the trade name S-Caine Patch. The Synera patch is specifically indicated for use on intact skin for superficial venous access or minor dermatologic procedures in patients aged 3 years and older.[14] Application is recommended for 20 to 30 minutes prior to venous cannulation. To avoid systemic toxicity, lidocaine/tetracaine patches should not be applied to broken or inflamed skin or to mucous membranes. Multiple patches should not be used simultaneously or in immediate succession. Synera is contraindicated in patients with known hypersensitivity to para-aminobenzoic acid. Studies have consistently produced favorable results, demonstrating that the lidocaine/tetracaine warming patch significantly reduced pain in children during IV cannulation versus placebo, with no effect on the number of successful cannulation attempts.[15,16]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.