Tumescent local anaesthesia for breast cancer surgery in elderly women: about 6 cases

Riff, Camille; Diaz, A; Blin, Olivier; Léone, Marc; Guilhaumou, Romain; Bourgoin, A

doi:10.1016/j.accpm.2018.05.008

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…29 But a few studies reported no clinical evidence of lidocaine systemic toxicity or epinephrine side effect in elderly patients during different surgical procedures and at different localisations, including some with high amounts of LA. Measured serum concentrations of total and unbound lidocaine were low during the 48 h. 34,51,52 In our study, amounts of LA in a standardized TLA with added epinephrine were required for head and neck procedures well below the maximum limit mentioned above. 49 None of the 0.8% affected patients had received significantly higher volumes or amounts of LA/ TLA.…”

Section: Cardiac Arrythmiamentioning

confidence: 53%

“…Otherwise, the anaesthetic effect lasts significantly longer in TLA due to the delayed absorption from the subcutaneous tissue. The maximum plasma levels are reached after 6–9 h. Therefore, toxic system reactions can occur several hours postoperatively 51 . In general, the potency of anaesthetic drugs is increased in the elderly 29 .…”

Section: Discussionmentioning

confidence: 99%

“…The maximum plasma levels are reached after 6-9 h. Therefore, toxic system reactions can occur several hours postoperatively. 51 In general, the potency of anaesthetic drugs is increased in the elderly. 29 But a few studies reported no clinical evidence of lidocaine systemic toxicity or epinephrine side effect in elderly patients during different surgical procedures and at different localisations, including some with high amounts of LA.…”

Section: Cardiac Arrythmiamentioning

confidence: 99%

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Risk analysis of systemic side effects of tumescent local anaesthesia in the surgical treatment of geriatric and multimorbid patients with skin cancer

Schnabl

Garbe

Breuninger

et al. 2022

Acad Dermatol Venereol

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Background: Due to demographic change and increased UV exposure, the number of dermatosurgical procedures in the elderly is increasing. Data on the occurrence of systemic side effects during and after treatment with tumescent local anaesthesia are limited and do not refer to details such as volume and composition of local anaesthetics or epinephrine additive. Objectives:The aim of this study was to investigate the risk of systemic side effects in elderly patients undergoing skin tumour surgery with tumescent local anaesthesia.Methods: Investigation of systemic complications in patients (≥75 years) who underwent head and neck skin tumour surgery under tumescent local anaesthesia at the

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Section: Cardiac Arrythmiamentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Cardiac Arrythmiamentioning

confidence: 99%

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Risk analysis of systemic side effects of tumescent local anaesthesia in the surgical treatment of geriatric and multimorbid patients with skin cancer

Schnabl

Garbe

Breuninger

et al. 2022

Acad Dermatol Venereol

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“…41 Tumescent local anesthesia allows a prolonged postoperative analgesia due to long-acting LA, such as ropivacaine and epinephrine supplement. 14,[40][41][42] Pichler et al studied twelve elderly patients with reconstruction of infraorbital skin defects in TLA. Five patients reported "slight" to "moderate" postoperative pain, seven patients had no pain.…”

Section: Advantages For Pain Managementmentioning

confidence: 99%

Tumescent local anesthesia in geriatric patients with head and neck skin cancer – a retrospective study of 782 patients

Schnabl,

Garbe,

Breuninger

et al. 2024

J Deutsche Derma Gesell

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SummaryBackground and ObjectivesDue to frailty, dermatosurgery in the elderly is preferably performed under tumescent local anesthesia, but data is limited. The aim was to evaluate tumescent local anesthesia for skin cancer surgery in the elderly with focus on clinical benefits (treatment processes, pain management) and local postoperative complication risk.Patients and MethodsInvestigation of patients ≥ 75 years with inpatient head and neck skin cancer surgery under tumescent local anesthesia.Results2,940 procedures in 782 patients (mean age 83.3 years) were performed with the aim of complete tumor resection during the inpatient stay. 3.8 (range: 1–20) interventions were done over an average of 4.9 days (range: 1–28). 43.2% did not require any postoperative analgesia. 53.5% received NSAIDs, 3.3% opioids. Infection (13.6%) was the most common local postoperative complication. Surgical intervention due to bleeding was required in 2.8%. None was hemoglobin relevant or life‐threatening. Suture dehiscence and necrosis were rare (0.6%).ConclusionsTumescent local anesthesia is an effective method for skin cancer surgery in the elderly. By avoiding general anesthesia, treatment processes can be optimized and anesthesiologic risks minimized. Local postoperative complications are still low and well treatable. The long‐lasting analgesia results in a reduced need for analgesics and drug interactions.

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“…1 Although initially intended for liposuction, application of this technique has widened to many procedures such as mastectomy and thyroidectomy. [1][2][3][4] Furthermore, this technique has a role in Endovenous Laser Therapy (EVLT) also. 5 TLA is a regional anesthetic technique wherein the diluted lidocaine and epinephrine solution in large volume is injected subcutaneously around the incision.…”

Section: Introductionmentioning

confidence: 99%

Tumescent Local Anesthesia in Parotid Abscess - Novel Application of Old Technique

Sethuraman

Gopi²,

Radhakrishnan³

et al. 2021

Kathmandu Univ. Med. J.

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Tumescent local anesthesia (TLA) is a regional anesthetic technique in which the diluted local anesthetic drug (commonly lidocaine) and epinephrine solution in large volume is injected subcutaneously around the site of incision. The main advantages of TLA are excellent bloodless field and longer duration of analgesia because of addition of epinephrine. Although TLA was used in various surgical procedures, there is no literature to date that has reported its use in the parotid region. Hence, we present an interesting case where this old technique found a novel application in avoiding general anesthesia and its sequelae. We also believe that it provides valuable information to doctors of various categories such as surgeons, Anesthesiologists and general practitioners/family physicians.

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Tumescent local anaesthesia for breast cancer surgery in elderly women: about 6 cases

Cited by 4 publications

References 5 publications

Risk analysis of systemic side effects of tumescent local anaesthesia in the surgical treatment of geriatric and multimorbid patients with skin cancer

Risk analysis of systemic side effects of tumescent local anaesthesia in the surgical treatment of geriatric and multimorbid patients with skin cancer

Tumescent local anesthesia in geriatric patients with head and neck skin cancer – a retrospective study of 782 patients

Tumescent Local Anesthesia in Parotid Abscess - Novel Application of Old Technique

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