Topical tac

Topical tac is a topical anesthetic solution[1] introduced by Pryor et al. in 1980. It is a mixture of 5 to 12% tetracaine, 0.05% adrenaline, and 4 or 10% cocaine hydrochloride (hence the "TAC" nomenclature). It has been used in ear, nose, and throat surgery and in the emergency department where numbing of the surface is needed rapidly. Use in the pediatric patient cohort has been documented, including when children have been injured in the eye, ear, or other sensitive locations.[2][3][4]

Due to drug diversion concerns surrounding the use of cocaine in medicine, along with concern regarding toxicity and expense, the cocaine was replaced with lidocaine and a new anesthetic was created - lidocaine, epinephrine, and tetracaine (LET).[5]

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  1. ^ Tipton, G. A.; DeWitt, G. W.; Eisenstein, S. J. (1 November 1989). "Topical TAC (tetracaine, adrenaline, cocaine) solution for local anesthesia in children: prescribing inconsistency and acute toxicity". Southern Medical Journal. 82 (11): 1344–1346. doi:10.1097/00007611-198911000-00004. PMID 2814620.
  2. ^ Appleton's Nursing Manual - "Cocaine"
  3. ^ Anderson, A. B.; Colecchi, C.; Baronoski, R.; DeWitt, T. G. (May 1990). "Local anesthesia in pediatric patients: topical TAC versus lidocaine". Annals of Emergency Medicine. 19 (5): 519–522. doi:10.1016/s0196-0644(05)82182-1. ISSN 0196-0644. PMID 2184706. S2CID 72722229.
  4. ^ Königs, Ingo; Wenskus, Julia; Boettcher, Johannes; Reinshagen, Konrad; Boettcher, Michael (December 2020). "Lidocaine-Epinephrine-Tetracaine Gel Is More Efficient than Eutectic Mixture of Local Anesthetics and Mepivacaine Injection for Pain Control during Skin Repair in Children: A Prospective, Propensity Score Matched Two-Center Study". European Journal of Pediatric Surgery. 30 (6): 512–516. doi:10.1055/s-0039-3400283. ISSN 1439-359X. PMID 31739347. S2CID 208170240.
  5. ^ Achar, Suraj; Kundu, Suriti (2002-07-01). "Principles of Office Anesthesia Part II: Topical Anesthesia". American Family Physician. 66 (1): 99–102. ISSN 0002-838X. PMID 12126037.