Tetracaine adverse effects

There is a potential risk that spinal anesthesia will cause apnea in premature infants. However, spinal anesthesia with a sound technique has been used safely in high-risk infants. Tetracaine was used in 142 such cases only two infants had serious adverse effects, one with unexplained but treatable apnea and one in whom too high a block resulted in respiratory arrest (196). 

Tetracaine is a highly lipid-soluble, potent aminoester. It is primarily used as a constituent of many different topical formulations and for spinal anesthesia. It is four times as potent as lidocaine, and unless great caution is taken in dosage, serious systemic adverse effects can develop. 

Reported local adverse effects of tetracaine include itch and a high incidence of erythema as a consequence of vasodilatation, which may actually be an advantage. There was no evidence of dermatitis (SEDA-20,127) (7). 

LET (4% lidocaine, 1 2,000 epinephrine, and 0.5% tetracaine) 1 to 3 mL directly applied to wound for 15 to 30 minutes Onset 20 to 30 minutes Duration not established Similar to TAC for face and scalp lacerations less effective on extremities No severe adverse effects reported... 

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