Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
-
Comparative Study
High-energy pulsed light source hair removal device used to evaluate the onset of action of a new topical anesthetic.
Topical anesthetic agents are widely used to mitigate the pain associated with laser and high-energy pulsed light source hair removal. ⋯ ELA-Max is an effective topical anesthetic agent comparable to EMLA under occlusion. It appears to be faster acting than EMLA, and along with its effectiveness without occlusion, may be an easier agent to use.
-
Reliable, long-acting local anesthetics reduce postoperative pain and make it easier to plan surgery. This is especially true when slow infusion tumescent anesthesia (SITA) is used. The anesthetic agent ropivacaine appears to meet the requirements of SITA especially well. ⋯ We regard ropivacaine as a major step forward in the use of local anesthesia.
-
Comparative Study
Lidocaine levels during the first two hours of infiltration of dilute anesthetic solution for tumescent liposuction: rapid versus slow delivery.
Tumescent anesthesia for liposuction with dilute lidocaine has been well documented to result in peak serum levels 4-14 hours after infiltration. Pharmacokinetic studies have shown that the rate of lidocaine absorption is related not only to dilution, but also to the speed of subcutaneous infiltration. Early studies with a more concentrated solution of lidocaine (1.0%) have shown that with rapid infusion, peak plasma levels may occur within 30 minutes. ⋯ Despite variability, the serum levels of lidocaine remained well within safety limits during infusion of tumescent solution and the first hours of the procedure when infused in rates up to 200 mg/min with spinal needles and/or small diameter multiholed infusion cannulas.
-
Intravenous conscious sedation is currently being widely utilized for outpatient surgery including dermatologic surgery. Even though this type of anesthesia is typically administered by a trained, licensed anesthetist, it is important for dermatologists who either intend to or are currently utilizing this type of anesthesia to be familiar with some of the methods and agents that are commonly employed. ⋯ Propofol when used in conjunction with fentanyl appears to be a safe, quick, and effective method of providing conscious sedation.
-
Multiple anesthetic approaches exist for full-face laser resurfacing. The propofol-ketamine technique is reviewed as a reasonable alternative to providing adequate anesthesia for full-face laser resurfacing in the office environment. ⋯ The propofol-ketamine technique appears to be an excellent alternative anesthetic approach to EMLA cream, tranquilizer-opioid regimens, or general inhalational anesthesia for facial laser resurfacing.