Safety of peak serum lidocaine concentration after Mohs micrographic surgery: A prospective cohort study

Alam, Murad; Ricci, Dominic; Havey, Jillian; Rademaker, Alfred; Witherspoon, Joslyn N.; West, Dennis P.

doi:10.1016/j.jaad.2009.08.046

Cited by 25 publications

(18 citation statements)

References 12 publications

(8 reference statements)

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“…Patients do not generally experience ill effects until serum lidocaine levels reach at least 3 μg/mL. At this level, nonspecific dizziness and drowsiness have been reported [53]. Perioral paresthesias, tinnitus, and muscular fasciculation may occur at 5 μg/mL [54].…”

Section: Toxicitymentioning

confidence: 99%

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Local Anesthesia: Evidence, Strategies, and Safety

et al. 2015

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The number of office-based procedures performed utilizing local anesthesia continues to rise, particularly in dermatologic settings. As more emphasis is placed on cost effectiveness in medicine, it is important to understand the role that office-based procedures can play in providing excellent dermatologic care. In addition, it is essential to continually demonstrate that local anesthesia administered in office-based settings is safe and effective in order to maintain a high standard of care within the specialty. Achieving adequate local anesthesia is imperative to ensure patient comfort, reduce anxiety, and promote optimal outcomes. The clinician should have a comprehensive understanding of the pathophysiology, mechanism of action, practical applications and techniques, and potential adverse events of various topical and injectable anesthetics in order to enhance patient satisfaction and safety. Lidocaine, which is the most commonly used local anesthetic, has a rapid onset, moderate duration, and excellent safety profile, making it a staple in office-based procedures.

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Section: Toxicitymentioning

confidence: 99%

“…In a prospective cohort study by Alam et al, serum lidocaine levels were measured before and after the first and second stages of Mohs surgery and before and after the third stage or wound repair [53]. The mean lidocaine dose per injection was 3 mL.…”

Section: Toxicitymentioning

confidence: 99%

Local Anesthesia: Evidence, Strategies, and Safety

et al. 2015

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“…It is metabolized by the liver with a half-life of 120 min when injected locally [31]. Toxicity from higher doses is first appreciated as nonspecific symptoms such as dizziness, lightheadedness, and drowsiness when lidocaine levels reach approximately 3 μg/mL.…”

Section: Lidocaine Toxicitymentioning

confidence: 99%

“…Fortunately, lidocaine toxicity from local injection is rare. A prospective cohort study of 20 patients, by Alam et al, sought to determine if the perioperative peak lidocaine levels at six different time points throughout Mohs surgery approached the threshold of lidocaine toxicity [31]. The mean serum lidocaine level during the six time points was undetectable (<0.1 μg/mL) [31].…”

Section: Lidocaine Toxicitymentioning

confidence: 99%

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Error Avoidance in Dermatologic Surgery

Decker

Lawrence

2015

Curr Derm Rep

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Surgical errors pose a significant source of morbidity, mortality, and expense within the health care system. While rates of errors within dermatologic surgery are low, there are certain areas of dermatologic surgery that are more prone to errors than others. These include site identification, specimen labeling, triage, lidocaine toxicity, needle sticks, electrosurgery, and laser surgery. Within these areas, continued research is being done to identify the source of the errors and establish protocols to minimize the risk.

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Complications of Mohs Micrographic Surgery

Ingraffea

Gloster

2011

Mohs Micrographic Surgery

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Safety of peak serum lidocaine concentration after Mohs micrographic surgery: A prospective cohort study

Cited by 25 publications

References 12 publications

Local Anesthesia: Evidence, Strategies, and Safety

Local Anesthesia: Evidence, Strategies, and Safety

Error Avoidance in Dermatologic Surgery

Complications of Mohs Micrographic Surgery

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