Practice Management

LET and TAC Trick

Lidocaine-epinephrine-tetracaine (LET) and tetracaine-epinephrine (Adrenalin)-cocaine (TAC) can be particularly helpful when you need to suture facial lacerations in children.

To confirm that I have sufficiently irrigated an eye that has been exposed to an alkaline substance, I use nitrazine paper strips to test the pH of the conjunctival fluid.

Children with lacerations that require suturing are typically afraid and uncooperative. The pain of a local lidocaine injection will increase their fear and lack of cooperation.

Avoiding toxicity from too much local anesthesia can be a challenge when suturing large lacerations or multiple lacerations.