Topical anesthesia for laceration repair: tetracaine versus TAC (tetracaine, adrenaline, and cocaine)

Am J Emerg Med. 1986 Jul;4(4):319-22. doi: 10.1016/0735-6757(86)90300-1.


Topical anesthetics have always had a place in anesthetizing mucous membranes. The earliest writing in Greek medical literature makes reference to the use of these topical anesthetizing agents. Previous studies utilized a mixture of tetracaine, Adrenaline, and cocaine in the pediatric population with increased patient compliance. In contrast, another study cites the increased risk of infection in cases where topical anesthetics in combination with potent vasoconstrictors are used. To examine the efficacy and safety of a tetracaine and a tetracaine, Adrenalin, and cocaine mixture (TAC), a randomized, double-blind study was undertaken. A total of 68 patients participated in the study, with 36 receiving TAC and 32 receiving tetracaine. The results indicate that the most efficacious use of TAC is on facial lacerations, regardless of length or depth. Of the 46 participants available for follow-up, one patient in the tetracaine group reported a wound infection. A recommendation of increased use of TAC on facial lacerations, in both the adult and pediatric populations, is made based on the results of this study.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Adult
  • Cocaine / administration & dosage*
  • Double-Blind Method
  • Epinephrine / administration & dosage*
  • Facial Injuries / therapy
  • Humans
  • Tetracaine / administration & dosage*
  • Wounds and Injuries / therapy*


  • Tetracaine
  • Cocaine
  • Epinephrine