Here at Children's Hospital of Wisconsin, we have been using
LET(LAT:Lidocaine/Adrenaline/Tetracaine) for almost a year in conjunction
with AC(Adrenaline/Cocaine) with great success. At first, there were some
skepticism, but now almost all the minor lacerations of scalp and face
are repaired with LAT. In the past, AC solution was supplied to our ED in a
sterile plastic syringes and was applied on a guaze or by cotton swab.
Then we began to mix them with methylcellulose to make a gel form by the
ED nurses.This gel form was made by mixing the AC solution with
Methylcellulose powder in a plastic cup which was not sterile. Although
we have not sought the infection rate from the gel form, I do not recall
LAT is exclusively used in gel form in our ED made under sterile
conditions by pharmacy and supplied in 1.5 cc sterile plastic
syringes. Since gel is the only form we use, it can be prepared in
batches by pharmacy without worrying about pssible contamination during
mixing in the ED as we have before with AC.
The shelf life of this preparation appears to be approx. 3 weeks with
antioxidant mixed in. After that it turns brown from Epinephrine
oxidation. I do not understand how the shelf life is prolonged by using
I feel why concern yourself with possible contamination when it can be
made sterily and stored for a reasonable amount of time.
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