Superficial skin surgery using topical 4% amethocaine gel (Ametop): A comparison with infiltrated lignocaine

Abstract

We assessed the efficacy and safety of a percutaneous preparation of 4% amethocaine (Ametop) when used to provide anaesthesia for shave excision of benign skin lesions. The study design was a single-centre, randomized, within-subject comparison of topical application of Ametop versus infiltrated lignocaine. The study group comprised 80 unpremedicated adult patients. Using a verbal rating scale, pain was assessed (1) during administration of the anaesthetic, (2) during removal of skin lesions and (3) during the procedure for haemostasis. At the end of skin surgery, patients' overall preference was also rated. On administration, injection of lignocaine produced varying amounts of pain in all patients, but in contrast Ametop produced no pain. During removal of lesions and haemostasis, the anaesthesia produced by Ametop was considered adequate, although less effective than lignocaine. However, the overall procedure involving Ametop was preferred by the majority of patients (P< 0.001). With pain-free application, the consequent greater freedom afforded by Ametop to anaesthetize multiple sites, and patient preference, Ametop can be considered a useful alternative to local injection of lignocaine for patients who require shave excision of superficial skin lesions.

Key Words:

• Amethocaine gel
• Ametop
• Superficial skin surgery
• Topical anaesthetic