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CME
Please see page 339 for the Editor’s Capsule Summary of this article.
Supervising editor: Steven M. Green, MD. Specific detailed information about possible conflict of interest for individual editors is available at https://www.annemergmed.com/editors.
Author contributions: SS, KP, and MK conceived the study, designed the trial, and obtained research funding. SS supervised the conduct of the trial and data collection and completed the statistical analysis. SS and KP drafted the article, and all authors contributed substantially to its revision. All authors take responsibility for the accuracy and integrity of all aspects of the research. SS takes responsibility for the paper as a whole.
All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist. The study was funded in part by a grant from the Foundation of Osteopathic Emergency Medicine Young Investigator’s Award.
Trial registration number: NCT04187417
Continuing Medical Education exam for this article is available at http://ecme.acep.org/diweb/catalog/t/51820.
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Pain management and sedation/original research
Short-Term Topical Tetracaine Is Highly Efficacious for the Treatment of Pain Caused by Corneal Abrasions: A Double-Blind, Randomized Clinical Trial
Presented at the American College of Emergency Physicians Scientific Assembly, October 2019, Denver, CO.
Stacia
Shipman
DO
∗
stacia.shipman@integrisok.com
Kelly
Painter
MD
Mark
Keuchel
DO
Charles
Bogie
MD
Department of Emergency Medicine, INTEGRIS Southwest Medical Center, Oklahoma City, OK
Department of Emergency Medicine
INTEGRIS Southwest Medical Center
Oklahoma City
OK
Department of Emergency Medicine, INTEGRIS Southwest Medical Center, Oklahoma City, OK
∗
Corresponding Author.
Study objective
The objective of this study is to show that patients with corneal abrasions would experience more pain relief with short-term topical tetracaine than placebo.
Methods
The study was a prospective, double-blind, randomized trial of tetracaine versus placebo set in the emergency department (ED). A total of 118 adults who presented with uncomplicated corneal abrasions were included and randomized. The intervention was either topical tetracaine or placebo applied every 30 minutes as needed for 24 hours. The primary outcome was the overall numeric rating scale pain score measured at the 24- to 48-hour ED follow-up examination.
Results
One hundred eleven patients were included in the final analysis, 56 in the tetracaine group and 55 in the placebo group. At the 24- to 48-hour follow-up, the overall numeric rating scale pain score after use of the study drops was significantly lower in the tetracaine group (1) versus placebo group (8) (Δ7; 95% confidence interval 6 to 8). Patients in the tetracaine group used less hydrocodone than those in the placebo group. The complication rates between the 2 groups were similar.
Conclusion
Short-term topical tetracaine is an efficacious analgesic for acute corneal abrasions, is associated with less hydrocodone use compared with placebo, and was found to be safe in this sample.
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