Preparation: Tetracaine (amethocaine) 4% as a gel. Individual tubes contain 1.5 g. A thick layer of cream should be placed over the appropriate area and an occlusive dressing placed to prevent loss.

Indication: Topical anaesthesia to skin, but not for mucous membranes: it will anaesthetize mucous membranes, but is absorbed very rapidly. Systemic effects are not seen.

Timing: Ametop takes 30 minutes to work effectively; it is faster-acting than EMLA, but does not last as long.

Problems with use: It does not cause vasoconstriction like EMLA. Tetracaine is a local anaesthetic of the ester type, unlike lidocaine and prilocaine which are amides. As a result, hypersensitivity to Ametop can produce erythema and urticaria more frequently than is seen with EMLA.