[Subcutaneous infusion anesthesia with prilocaine diluted with Ringer's lactate]

Area of Science:

• Dermatologic Surgery
• Anesthesiology
• Medical Devices

Background:

• Tumescent anesthesia, while effective for dermatologic surgery, often requires manual cannula guidance.
• Existing pumps facilitate large anesthetic injections but still necessitate physician presence during infusion.
• A novel approach using an infusomat for slow, automatic subcutaneous anesthetic delivery has been developed.

Purpose of the Study:

• To evaluate the efficacy and safety of subcutaneous infusion anesthesia (SIA) for dermatologic procedures.
• To assess patient comfort and preference for SIA compared to traditional anesthesia methods.
• To determine the feasibility of SIA for a wide range of skin surgeries and patient demographics.

Main Methods:

• SIA involved slow, automatic infusion of diluted prilocaine in Ringer's solution via an infusomat.
• Infusion rates ranged from 40-1500 ml/hr, with volumes up to 1000 ml, using needles from 21- to 30-gauge.
• The technique was applied to 502 patients undergoing diverse procedures, including tumor excisions, vein stripping, and lymph node dissections.

Main Results:

• No severe complications were reported in the 502 patients treated with SIA.
• Postoperative recovery was consistently rapid across all patient groups.
• A significant majority (91%) of patients preferred SIA over previous anesthesia experiences for similar operations.

Conclusions:

• Subcutaneous infusion anesthesia (SIA) using diluted prilocaine in Ringer's solution is an economical, safe, and comfortable technique.
• SIA is suitable for nearly all skin operations, offering benefits for children and anxious patients.
• The automatic infusion system allows for physician detachment during administration, enhancing patient comfort and potentially workflow efficiency.