[Tumescent anaesthesia for dermatological surgery. Plasma concentrations of lidocaine and prilocaine].
BACKGROUND
Tumescent anaesthesia is currently used for several dermatological procedures. The objective of this study was to determine the plasma concentrations of local anaesthetics under real operating conditions with this anaesthetic technique.


METHODS
A total of 31 patients received 3 different anaesthetic solutions with prilocaine and lidocaine for several surgical procedures. The concentrations of local anaesthetics, methemoglobin, epinephrine as well as the occurrence of adverse reactions were determined 30 min, 1 h, 3 h, 6 h, 12 h and 24 h after administration


RESULTS
Maximum plasma concentrations of prilocaine were measured predominantly after 3 and 6 h, for lidocaine after 6 h. In two patients maximum plasma levels occurred 24 h after infiltration. Although toxic concentrations were not exceeded, side-effects could be observed in four patients.


CONCLUSIONS
Even if the measured concentrations of local anaesthetics appeared to be safe, slight and moderate side-effects could be observed in 12.9% of cases. Maximum plasma levels of local anaesthetics may still occur 24 h after administration.
Rudlof
K
K
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103 Leipzig. Kristina.Rudlof@medizin.uni-leipzig.de
Rüffert
H
H
Wehner
M
M
Wetzig
T
T
Eichhorn
K
K
Olthoff
D
D
D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D062109:Dermatologic Surgical Procedures; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D008297:Male; D008706:Methemoglobin / Q000378:metabolism; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011318:Prilocaine / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D014662:Vasoconstrictor Agents / Q000097:blood
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D011318:Prilocaine; D008706:Methemoglobin; D008012:Lidocaine; D004837:Epinephrine