Comparison of anesthetic efficacy of Lidocaine (4%), Epinephrine (0.1%), and Tetracaine (0.5%) topical gel (LET) applied three times for 10 minutes each time vs. once for 30 minutes prior to suturing simple lacerations in children aged 7-17 years.

Randomized single-blinded clinical trial with convenience sampling of the anesthetic efficacy of a single 30-minute application vs three 10-minute applications of Lidocaine (4%), Epinephrine (0.1%), and Tetracaine (0.5%) topical gel (LET) prior to suturing simple lacerations in children aged 7-17 years seen in the Emergency Department.

Inclusion Criteria:

• Simple <= 3cm lacerations requiring suturing (as decided by clinician care providers)
• Plan to suture with simple interrupted sutures

Exclusion Criteria:

• Lacerations involving the hands, feet, genitals, tongue, mucus membranes, nose, ears, or occurring over joints
• Patients whose primary language was neither English nor Spanish
• Developmentally delayed or disabled patient such that they were unable to give a pain score
• Patients requiring procedural sedation or anxiolysis with oral or intranasal midazolam

No plan

During the patient's emergency department visit until time of discharge.

• Unable to blind the patient and nurse caring for the patient
• Wide age range from which we recruited patients
• We included children only age 7 years and older in order to be able to obtain a self-reported VAS pain score
• Majority of lacerations were on the face / scalp
• Sustaining a laceration and then being in an emergency department is already traumatic for young children; could interfere with pain scores

Investigator and nurse applied intervention and masked the intervention from the care provider. Separate nurse not caring for the patient, blinded to the intervention, brought in to obtain pain score (outcome)