Drug management in skin surgery

Drugs
C Lawrence

Abstract

Lidocaine (lignocaine) 1% with epinephrine (adrenaline) 1:200,000 (maximum dose 40mL) is the agent of choice in skin surgery. It can be used at all sites except the fingers, toes and penis, where epinephrine should be avoided. Epinephrine-induced vasoconstriction delays local anaesthetic clearance, thus prolonging its effect and, by reducing peak blood lidocaine concentrations, enables a higher maximum dose to be used. Adding epinephrine, however, introduces the possibility of a drug interaction with tricyclic antidepressants and nonselective beta-blockers. Also, injection pain is greater because of the acidic sodium metabisulphite that has to be added to prevent epinephrine oxidation. Injection pain can be reduced by buffering the solution using sodium bicarbonate. There are no drug interactions that prevent the use of plain lidocaine: injection pain is least with 0.5% solutions. Injection of large volumes of very dilute lidocaine solutions (tumescent anaesthesia) enables higher maximum doses of lidocaine to be tolerated and large areas to be anaesthetised by infiltration. Amethocaine gel is a faster acting and more effective topical anaesthetic compared with eutectic lidocaine-prilocaine cream, but is a topical sensitiser. In...Continue Reading

Citations

Feb 14, 1998·Dermatologic Clinics·E Dunlavey, B Leshin
Mar 9, 2012·Expert Opinion on Drug Safety·Suzanne BerkmanTina Alster
Dec 20, 2008·Clinics in Dermatology·Marcia S Driscoll, Jane M Grant-Kels
Nov 21, 2007·Journal of the American Academy of Dermatology·Marcia S Driscoll, Jane M Grant-Kels
May 9, 2006·Dermatologic Clinics·Susan M Sweeney, Mary E Maloney
Jun 22, 2012·International Journal of Dermatology·Firas Al-QarqazZiad Al Dabbagh
Sep 21, 2016·Journal of the American Academy of Dermatology·Amy Kalowitz BieberJennifer A Stein
Dec 8, 2016·Obstetrics and Gynecology·Amy Kalowitz BieberMiriam Keltz Pomeranz
Sep 19, 2001·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·I C Vossinakis
Jun 24, 2015·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Monica StankiewiczSonya Osborne
Aug 24, 1999·Postgraduate Medicine·D W SmithS C DeBerard
Mar 20, 2021·International Journal of Dermatology·Frank WinsettRichard F Wagner

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Related Papers

Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
B K Chen, L F Eichenfield
Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
Kristen A Richards, Thomas Stasko
Journal of the American Academy of Dermatology
D E Gormley
Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
P M FriedmanR G Geronemus
Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]
N F Eaglstein
© 2021 Meta ULC. All rights reserved