title: Sentinel lymph node biopsy under local anaesthesia versus general anaesthesia: reliability and cost-effectiveness analysis in 153 patients with malignant melanoma.
abstract: OBJECTIVE
  The aim of our study was to evaluate feasibility, reliability and cost-benefit balance of sentinel node (SN) biopsies conducted under local anaesthesia (LA) in patients affected by stage I-B or II cutaneous melanoma.
  
  
  METHODS
  A retrospective analysis was carried out in 153 patients, evaluating the number of harvested lymph nodes, perioperative and postoperative complications, operating time and operating room costs, comparing interventions under LA and general anaesthesia (GA). Operations were carried out under LA in 112 cases (73%) and under GA in the remaining 41(27%).
  
  
  RESULTS
  The mean number of removed SN was overall higher in the GA group but was not significantly different under LA with respect to the subgroups of axillary biopsies. No difference was noted in the number of complications. Operating time was significantly shorter under LA, with significantly lower costs.
  
  
  CONCLUSIONS
  LA for groin and axillary SN biopsies can be a reliable and effective alternative to GA in melanoma patients, with shorter operating time, lower costs and without the side-effects and risks associated with GA.
authors.affiliation: Department of Surgery, University of Perugia, Perugia, Italy. piero.covarelli@med.unipg.it
authors.forename: P
authors.initials: P
authors.lastname: Covarelli
authors.forename: M
authors.initials: M
authors.lastname: Badolato
authors.forename: G M
authors.initials: GM
authors.lastname: Tomassini
authors.forename: V
authors.initials: V
authors.lastname: Poponesi
authors.forename: C
authors.initials: C
authors.lastname: Listorti
authors.forename: E
authors.initials: E
authors.lastname: Castellani
authors.forename: C
authors.initials: C
authors.lastname: Boselli
authors.forename: G
authors.initials: G
authors.lastname: Noya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000191:economics; D000772:Anesthesia, Local / Q000191:economics; D000779:Anesthetics, Local; D002045:Bupivacaine; D002648:Child; D002675:Child, Preschool; D004396:Coloring Agents; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D008619:Mepivacaine; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics; D011183:Postoperative Complications / Q000453:epidemiology; D015641:Radiography, Interventional; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000191:economics / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin; D013997:Time Factors; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D004396:Coloring Agents; D019275:Radiopharmaceuticals; D012394:Rosaniline Dyes; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid; D008619:Mepivacaine; C008769:sulfan blue; D002045:Bupivacaine