Journal of the American Academy of Dermatology
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Performance measures serve as a method of assessing and reporting on the quality of care that physicians are delivering to their patients. Although measures have been developed and integrated into other fields of medicine, a comprehensive set of measures specific to the specialty of dermatology is lacking. It is likely that quality measures will become an increasingly significant component of health care, thus it is important for dermatologists to actively participate in their development. There are multiple topics relevant to the various components of dermatology practice (medical, surgical, and cosmetic dermatology and dermatopathology) upon which measures can be based.
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J. Am. Acad. Dermatol. · Jul 2010
Safety of peak serum lidocaine concentration after Mohs micrographic surgery: a prospective cohort study.
Large volumes of dilute local anesthesia are increasingly used not only for liposuction but also for other large cutaneous surgeries, including skin cancer excision. Although the lidocaine serum levels and peaks after injection of tumescent anesthesia in the trunk were shown to be safe even when used in high doses, the levels after use of less dilute (1% lidocaine) solutions for facial cancer surgery have not been described. ⋯ Lidocaine use during Mohs micrographic surgery does not appear to result in serum lidocaine levels approaching toxic levels even when relatively high total lidocaine doses are used. There is an association between higher total lidocaine dose and perioperative peak serum lidocaine level.
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J. Am. Acad. Dermatol. · Jun 2010
Efficacy of tumescent local anesthesia with variable lidocaine concentration in 3430 consecutive cases of liposuction.
Lidocaine toxicity is a potential complication related to using tumescent local anesthesia (TLA) as the exclusive form of pain management in surgical procedures. ⋯ For patients undergoing liposuction using TLA exclusively, the concentration of lidocaine in the normal saline solution required for adequate anesthesia is 400 mg/L for most body areas and 500 mg/L for some sensitive areas.