//fpnotebook.com/
LET Anesthesia
Aka: LET Anesthesia, Lidocaine-Epinephrine-Tetracaine
- See Also
- Local Skin Anesthesia
- Digital Block
- Lidocaine Local Skin Anesthesia (Xylocaine)
- EMLA cream
- Indication: Skin Laceration Repair
- Topical Anesthetic prior to local injection
- Replaces Tetracaine-Adrenaline-Cocaine (TAC)
- Safe down to age 2 years
- Use
- Apply 1-3 ml to Laceration with cotton swab
- Secure remainder of dose using gauze
- Tape for 20-30 minutes
- Do not exceed 4 mg/kg of Lidocaine (up to 280 mg)
- Lidocaine 4% is 40 mg/ml (7 ml = 280 mg)
- Recipe
- Ingredients
- Lidocaine HCL USP 4000 mg
- Epinephrine Bitartrate (55% Epinephrine) USP 180 mg
- Tetracaine HCl USP 500 mg
- Sodium Metabisulfite 75 mg
- Improves stability of Epinephrine
- Sterile Water for Irrigation qs add 100 ml
- Final concentrations
- Lidocaine 4%
- Epinephrine 0.1% or 1:1000
- Tetracaine 0.5%
- Preparation
- Place powdered ingredients in graduated cylinder
- Add to sterile water to reach 100 ml total
- Sterilize through 0.2 u filter
- Storage
- Store in a light resistant container
- Stability
- Lasts 6 months refrigerated
- Lasts 4 weeks at room Temperature
- Discard if solution discolors (should be clear)
- Gel preparation (better near mucous membranes)
- Start with 3 ml of LET solution (See above)
- Add 150 mg Methylcellulose 4000 cps
- Stir for 2-3 minutes
- Use immediately
- Suppliers
- Galliput, Inc. St Paul, MN, (800) 423-6967
- Hawkins Pharmaceutical Group
- http://www.HawkinsPharmaceutical.com
- Efficacy
- Effective alternative to TAC
- Advantages over TAC
- Less potential for toxicity
- Not a controlled substance
- Less expensive than TAC
- References
- Kundu (2002) Am Fam Physician 66(1):99-102 [PubMed]
- Schilling (1995) Ann Emerg Med 25(2):203-8 [PubMed]