Tetracaine gel for local anaesthesia

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Tetracaine gel for local anaesthesia

This leaflet is about the use of tetracaine gel to make an area of skin numb. This is called local anaesthesia. The gel may be used before taking blood with a needle or putting in a drip (cannula), or before a small surgical procedure that might be painful.

Information Standard - Health & care information your can trustThis leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again. 

Name of drug

Tetracaine gel, Amethocaine gel
Brand name:
The gel contains 4% tetracaine.

Why is it important to use this cream?

The gel will help reduce any pain or discomfort that your child may feel during a minor procedure, such as when blood is taken or a drip (cannula) is put in, or during a small surgical procedure such as removing a lump. If the gel is not applied, the procedure may have to be delayed or cancelled, or your child may feel pain or discomfort during the procedure.

What is tetracaine gel available as?

Tetracaine gel comes in tubes containing 1.5 g of gel.

When should I use tetracaine gel?

  • The gel needs to be applied between 30 and 45 minutes before the procedure is due to be done. 
  • The person giving you the gel will tell you when to apply it and where to apply it on your child’s body. They will probably ask you to apply gel to more than one place.
  • If the procedure is delayed and the effect of the gel has worn off, ask your doctor or nurse for advice before applying any more.

How much gel should I use?

Your doctor or nurse will tell you how much gel to apply – this is the amount that is right for your child. They may tell you to apply a whole tube of gel to each site, or part of a tube.

It is important that you follow the doctor or nurse’s instructions about how much to use.

How should I give it?

  • Squeeze the gel from the tube onto the area of skin to be numbed. Do not rub it in.
  • Place a waterproof dressing (plaster) over the gel to keep it in place. You will be given these with the gel. 
  • Make a note of the time that you applied the gel.
  • Wash your hands properly with soap and water, as soon as you have finished applying the gel.
  • If your child has not yet had the procedure, take off the dressing 1 hours after you applied it and wipe off the gel with a tissue.

Do not apply the gel to skin that has a rash or eczema or is sore, bleeding or has a scab.

The gel must not be applied to the eyes, ears, nose, inside the mouth, or near the back passage (anus) or genitals.

When should the gel start to work?

The skin should be numb enough after about 30 minutes for blood to be taken using a needle, and after about 45 minutes if a drip is being put in. 

The skin will stay numb for 4-6 hours.

What if my child is sick (vomits)?

You do not need to worry. The gel will still work if your child is sick. Do not apply any extra gel.

What if I forget to apply it?

If you forget to apply the gel, or you applied it late, tell the person who is going to do the procedure. They may want to delay the procedure.

Do not apply extra gel. This will not make it work faster.

What if I apply too much?

You are unlikely to do harm if you apply extra gel by mistake.
If you are concerned that you may have applied too much gel, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales). Have the gel packet with you when you telephone for advice.

Tetracaine gel can be dangerous if it gets inside the body. If your child has tingling or numbness of the tongue, ringing in the ears, feels sick or is sick (vomits) or has twitching or a convulsion (fit), take your child to hospital straight away.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Side effects you must do something about
  • If blisters form on the skin after applying the gel, take the gel off with a tissue and rinse the area gently with running water. Contact your doctor or nurse for advice.
  • If your child develops a skin rash or swelling of the face or tongue, they may be allergic to the gel. Remove any gel, rinse the skin with water and contact your doctor straight away.
Other side-effects you need to know about
  • Some children with allergies seem to react more to tetracaine gel, if this happens ask your doctor or nurse about an alternative local anaesthetic.
  • The gel may make the skin itch. This doesn’t usually last long and should stop when the gel is removed. If your child’s skin is still itching after a day, contact your doctor.

  • There may be some redness or swelling of the skin under the gel. This should go away once the effect of the gel wears off. If it is still a problem after a day, contact your doctor. Be aware that redness and swelling may also be caused by the needle or surgical procedure.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.

Can other medicines be given at the same time as using tetracaine gel?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
  • If your child is taking any medicines, tell the doctor or nurse who gave you the gel. If you forget to do this, check before you apply the gel. This includes herbal or complementary medicines.

Is there anything else I need to know about tetracaine gel?

If you think someone may have swallowed some gel, contact your doctor immediately.

Do not apply the gel anywhere inside the body (inside the mouth or in ears, eyes, genitals or back passage). It must only be used on the skin.

  • Your child’s skin may react to this gel even if they have used it before without having a reaction.
  • Do not leave the gel on the skin for more than 2 hours. Ideally it should be removed after 1 hour.
  • Only use the gel for your child. Never use it for anyone else, even if their condition appears to be the same, as this could do harm.
  • If you think someone else may have used the gel by accident, contact your doctor for advice.
  • Make sure that the gel you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old gel to your pharmacist to dispose of.
  • Once you have opened a tube of gel, throw away any unused gel or return it to the pharmacist.

Where should I keep this medicine?

  • Keep tubes of gel in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information

Your child’s doctor, pharmacist or nurse will be able to give you more information about tetracaine gel and about medicines used to numb the skin (local anaesthetics).

You can also get useful information from: 
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