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Procedures such as laceration repair, which at one time required the use of painful infiltrative anesthetics, can now be accomplished safely and comfortably with the use of topical anesthetics. An additional advantage of topical anesthetics in laceration repair is that wound margins are not distorted.
Injecting the local anesthetic may be painful and cause adrenergic stimulation, thereby reducing the effectiveness of the local anesthetic. The adrenergic stimulation can be anticipated using the intravenous moderate sedation before injection of the local anesthetic under close monitoring of blood pressure and oxygenation.