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Related Experiment Videos

Drug management in skin surgery

C Lawrence1

  • 1Royal Victoria Infirmary, Newcastle upon Tyne, England.

Drugs
|December 1, 1996
PubMed
Summary

Lidocaine with epinephrine is preferred for skin surgery, but plain lidocaine offers less injection pain and no drug interactions. Tumescent anesthesia allows higher doses for larger areas.

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Area of Science:

  • Dermatology
  • Anesthesiology
  • Pharmacology

Background:

  • Lidocaine with epinephrine is the standard local anesthetic for skin surgery.
  • Epinephrine enhances lidocaine's duration and maximum dose but carries risks.
  • Plain lidocaine and tumescent anesthesia offer alternatives with different risk-benefit profiles.

Purpose of the Study:

  • To review the use of lidocaine with and without epinephrine in skin surgery.
  • To compare anesthetic efficacy, safety, and patient factors.
  • To provide guidance on anesthetic choices and perioperative management.

Main Methods:

  • Literature review of lidocaine and epinephrine use in skin surgery.
  • Analysis of anesthetic properties, drug interactions, and pain management.
  • Evaluation of prophylactic measures for infection and bleeding.

Main Results:

  • Lidocaine with epinephrine offers prolonged effect and higher dosage but risks interactions and increased injection pain.
  • Plain lidocaine and buffered solutions reduce injection pain.
  • Tumescent anesthesia allows larger volume infiltration for extensive procedures.
  • Amethocaine gel is effective topically but is a sensitizer.
  • Prophylactic antibiotics and mupirocin may prevent infections.
  • Aspirin cessation is recommended for patients with prolonged bleeding times.

Conclusions:

  • Anesthetic choice depends on surgical site, patient risk, and desired effect.
  • Managing injection pain and potential drug interactions is crucial.
  • Perioperative strategies can mitigate risks of infection and bleeding.

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