Topical Anaesthesia =================== þ TAC for kids: - Mercy Hospital recipe: 3 cc with: .25% tetracaine .025% adrenaline 5.9% cocaine - can approximate with: 2 cc of 10% cocaine 2 cc of .5% tetracaine 1 cc 1:1000 (0.1%) adrenaline þ XAP (Xylocaine/Adrenaline/Pontocaine) - for kids and adults: - Recipe: + 2% viscous Xylocaine (lidocaine) 15 cc + Topical (Nor?)epi (Adrenaline) 1:1000 7.5 cc + tetracaine (Pontocaine) 2% 7.5 cc þ LET (Lidocaine/Epinephrine/Tetracaine): Tetracaine 2% 30 mL (Refrigerated) Epinephrine 1:1000 30 mL (30 mL vial for IV use) Lidocaine, Viscous 2% 60 mL Mix items thoroughly into a uniform solution. Draw 3 ml into ORAL syringes and cap. Assign a 30 day expiration date. Refrigerate. - use up to 3 cc for kids up to 3, up to 5 cc for older kids and adults; leave on until blanched or 20 minutes [Wase RE, Cardwell P. XAP - an alternative to cocaine for topical anesthesia. Ann Emerg Med 1993; 22(11):1776.] - "We've had six months of pretty good results using the LET (lidocaine 4%, epinephrine 0.1%, tetracaine 0.5%) solution described in Annals of Emergency Medicine, 25:2, page 203, February 1995." Mark L. Boettger, MD, FACEP Another recipe: LAT Gel (Lidocaine 4%, Adrenaline 1:2000, Tetracaine 0.5%) Weigh out 4 gm Lidocaine Powder, 0.05 gm epinephrine bitartrate powder, and 0.5 gm tetracaine HCL powder. Add powders to 5 to 7 ml of sterile water. Transfer solution to laminar flow hood. Filter the solution using a 0.22 micron filter. Transfer solution to a sterile glass container. Add small amount of sterile KY jelly, mix well. QS to 100 ml with sterile KY jelly. Mix thoroughly. Transfer to 3 ml syringes. Label. This is how our parmacy does it - expires at 6 months and is kept refrigerated. It produces a thick gel and the consistency is nice for spreading it like cold KY on the wound - spreads like jam and melts a little. Charles Sea, MD, FACEP Ochsner Hospital, New Orleans, La. References: