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1 of Table 5

Synthesis Table– 5: Synera Patch

Practice Area: Synera Patch

Topic / Citation / Sample / Key Findings / Comments
Synera / Singer, AJ, Taira, BR, Chisena, BA, Gupta, N and Chipley J
Warm Lidocaine/Tetracaine Patch Versus Placebo Before Pediatric Intravenous Cannulation: A Randomized Controlled Trial
Annals of Emergency Medicine 2008, 52(1) 41-47. / 3-17 yrs old
45 patients mean age 10 yrs
Pediatric ED
RCT / Median pain (1-40 mm) was lower in treatment group (20-59mm). No change in success rate. Adequate pain relief more common in treatment
Triage nurse correctly identified those pts needing IV and applied patch before MD saw patient Mean duration of patch = 39 min
Modest reduction in pain did not alter success rate / Transdermal patch that includes a oxygen activated heating pod – contain both lidocaine and tetracaine (Placebo patch used with drug patch) applied at least 20 minutes in advance
eutectic mixture- has a melting point lower than the of an individual component.. 2 drugs melt together that is more permeable than a solid
Synera / Sawyer J, Febbraro S, et al
Heated lidocaine/tetracaine patch ( Synera, Rapydan) compared with lidocaine/prilocaine cream (EMLA) for topical anaesthesia before vascular access
British Journal of Anaesthesia 2009; 102(2) 210-215. / 82 adults
Volunteers
Double blind
paired
RCT / Received each treatment
10, 20, 30 or 60 min
Vas scores significantly lower for patch in treatment groups 10-30 min, the same at 60 min
Product removed and investigator observed skin and started IV / Application time as short as 10 minutes was better than EMLA
Patch produced more erythema and EMLA produced more blanching
Synera / Curry SE & Finkel JC
Use of the Synera Patch for Local Anesthesia Before Vascular Access Procedures;A Randomized, Double- Blind Placebor-Controlled Study
Amercia Academy of Pain Medicine 2007, 8(6) 497-502 / 40 healthy adults
Received both Synera and placebo
RCT / Synera and placebo patch-20 minutes
Patients and Investigators rated synera with less/no pain. More subjects rated Synera as giving adequate analgesia than the placebo patch / Median pain score lower, More subjects reported pain relief and would use Synera. Transient mild erythema with Synera
Transdermal / Sethna, NF, Verghese, ST, Hannaliah, RS et al
Randomized Controlled Trial to Evaluate S-Caine Patch for Reducing Pain Associated with Vascular Access in Children
Anesthesiology 2005 102(2) 403-408 / 64 children vascular access
RCT / Oucher Scale and observer score
Patch produced significantly more pain relief. 59% of children reported no pain compared to 20 % in control / 20 minute application
Mild erythema <38%
Edema <2 %
Transdermal / Wiles, MD, Dobson, SA & Moppett, IK
The effect of anew topical local anaesthetic delivery system on forearm skin blood flow reactivity
Anaesthesia 2010, 65; 178-183. / 20 healthy male volunteers 20-33 years
480 transient test were taken / Measured blood flow before and after application of EMLA , Ametop and Patch, Determine sensory block and flow flux measures / Ametop (UK) had significant increase in flow; Patch did not have increase , EMLA had no increase and also no reactivity