Dell Medical School, University of Texas at Austin, Austin, Texas.
Cutaneous Surgery Center of Austin, Austin, Texas.
Dermatol Surg. 2020 Jan;46(1):26-30. doi: 10.1097/DSS.0000000000001900.
Recently, the safety of lidocaine plus epinephrine use in outpatient surgery has come under scrutiny despite its long history of use in outpatient dermatologic procedures and surgeries.
To assess the frequency of crash cart and other emergency interventions during Mohs micrographic surgery when lidocaine plus epinephrine is used as a local anesthetic and evaluate patient comorbidities associated with these events.
A retrospective chart review was conducted in an outpatient Mohs micrographic surgery clinic.
One thousand one hundred twenty-seven Mohs cases were reviewed from the period of March 2015 to June 2016 with 864 meeting the inclusion criteria of patient weight, medical history, and amount of lidocaine administered recorded. No adverse events requiring emergency intervention with a crash cart or transfer to the emergency department occurred despite a patient population with advanced age and a wide range of comorbidities.
No serious adverse events requiring emergency intervention were associated with lidocaine with epinephrine doses administered below the Food and Drug Administration recommended maximum. The authors did not find evidence from this study or after a literature search to support the requirement for a crash cart and other emergency equipment to be present during procedures.
尽管利多卡因加肾上腺素在门诊皮肤科手术和手术中已有很长的使用历史，但最近其在门诊手术中的安全性受到了质疑。
评估在使用利多卡因加肾上腺素作为局部麻醉剂的情况下，行 Mohs 显微外科手术时，急救车和其他紧急干预的频率，并评估与这些事件相关的患者合并症。
对门诊 Mohs 显微外科手术诊所进行了回顾性图表审查。
对 2015 年 3 月至 2016 年 6 月期间的 1127 例 Mohs 病例进行了回顾，其中 864 例符合纳入标准，记录了患者体重、病史和给予的利多卡因量。尽管患者年龄较大，合并症种类繁多，但没有发生需要急救车或转至急诊的不良事件。
尽管给予的利多卡因加肾上腺素剂量低于食品和药物管理局推荐的最大剂量，但与接受治疗相关的严重不良事件无需进行紧急干预。作者在这项研究或文献检索中均未发现证据支持在手术过程中需要配备急救车和其他急救设备。
