Safety of Intradermal/Subcutaneous Lidocaine With Epinephrine Use in Dermatologic Surgery.
Aged
Anesthetics, Local
/ administration & dosage
Epinephrine
/ administration & dosage
Female
Humans
Injections, Intradermal
Injections, Subcutaneous
Lidocaine
/ administration & dosage
Male
Middle Aged
Mohs Surgery
/ adverse effects
Postoperative Complications
/ epidemiology
Retrospective Studies
Sympathomimetics
/ administration & dosage
Journal
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
ISSN: 1524-4725
Titre abrégé: Dermatol Surg
Pays: United States
ID NLM: 9504371
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
5
3
2019
medline:
4
4
2020
entrez:
5
3
2019
Statut:
ppublish
Résumé
Recently, the safety of lidocaine plus epinephrine use in outpatient surgery has come under scrutiny despite its long history of use in outpatient dermatologic procedures and surgeries. To assess the frequency of crash cart and other emergency interventions during Mohs micrographic surgery when lidocaine plus epinephrine is used as a local anesthetic and evaluate patient comorbidities associated with these events. A retrospective chart review was conducted in an outpatient Mohs micrographic surgery clinic. One thousand one hundred twenty-seven Mohs cases were reviewed from the period of March 2015 to June 2016 with 864 meeting the inclusion criteria of patient weight, medical history, and amount of lidocaine administered recorded. No adverse events requiring emergency intervention with a crash cart or transfer to the emergency department occurred despite a patient population with advanced age and a wide range of comorbidities. No serious adverse events requiring emergency intervention were associated with lidocaine with epinephrine doses administered below the Food and Drug Administration recommended maximum. The authors did not find evidence from this study or after a literature search to support the requirement for a crash cart and other emergency equipment to be present during procedures.
Sections du résumé
BACKGROUND
Recently, the safety of lidocaine plus epinephrine use in outpatient surgery has come under scrutiny despite its long history of use in outpatient dermatologic procedures and surgeries.
OBJECTIVE
To assess the frequency of crash cart and other emergency interventions during Mohs micrographic surgery when lidocaine plus epinephrine is used as a local anesthetic and evaluate patient comorbidities associated with these events.
MATERIALS AND METHODS
A retrospective chart review was conducted in an outpatient Mohs micrographic surgery clinic.
RESULTS
One thousand one hundred twenty-seven Mohs cases were reviewed from the period of March 2015 to June 2016 with 864 meeting the inclusion criteria of patient weight, medical history, and amount of lidocaine administered recorded. No adverse events requiring emergency intervention with a crash cart or transfer to the emergency department occurred despite a patient population with advanced age and a wide range of comorbidities.
CONCLUSION
No serious adverse events requiring emergency intervention were associated with lidocaine with epinephrine doses administered below the Food and Drug Administration recommended maximum. The authors did not find evidence from this study or after a literature search to support the requirement for a crash cart and other emergency equipment to be present during procedures.
Identifiants
pubmed: 30829774
doi: 10.1097/DSS.0000000000001900
pii: 00042728-202001000-00005
doi:
Substances chimiques
Anesthetics, Local
0
Sympathomimetics
0
Lidocaine
98PI200987
Epinephrine
YKH834O4BH
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
26-30Références
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