Topical anesthetics in children: agents and techniques that equally comfort patients, parents, and clinicians

Topical anesthetics are increasingly important, as the number of outpatient surgeries for dermatologic problems in infants and children is steadily gr owing. This noninvasive modality of anesthetic delivery in conjunction with a reassuring environment may minimize the discomfort of otherwise painful procedures. Since the 1880s, when cocaine was first used as a topical ophth almologic anesthetic, many ester- and amide-based local anesthetics have be en developed for a variety of simple and complex procedures. The pediatric dermatologist's arsenal of topical anesthetic preparations is increasing wi th the development of novel vehicles of transdermal delivery and the use of anesthetics In combination. Eutectic, mixture of local anesthetics is curr ently the most frequently prescribed topical agent, though the use of ELA-m ax, another lidocaine-containing. preparation, is gaining momentum, especia lly in the neonatal population. Amethocaine, tetracaine, iontophoresis, and the S-caine patch, a product on the horizon for use in the pediatric popul ation, also are included in this discussion. (C) 2001 Lippincott Williams & Wilkins, Inc.