Effect of different types of anaesthesia including percutaneous local anaesthesia on survival of experimental skin flaps.

Local anaesthesia by epicutaneous application of the ketocaine solution A2358 gave survival of experimental skin flaps in the guinea pig which corresponded on average to 71% of the total flap. The survival after pentobarbitone anaesthesia, general anaesthesia with ether, and infiltration of prilocaine without and with adrenalin varied between 41 and 53%. The difference in effect between percutaneous anaesthesia with A2358 and the other procedures was statistically significant (p less than 0.001). Epicutaneous application of A2358 followed by one of the other forms of anaesthesia gave a flap survival that did not differ from that following local anaesthesia with A2358 alone, except when followed by injection of prilocaine with adrenalin. The improved survival after epicutaneously applied A2358 is probably attributable to an effect on the peripheral vascular bed resulting in increasing blood supply and nutrition. It may be possible that A2358, for example, could be used in man as a complement to other forms of anaesthesia to provide enhanced tissue survival in skin flaps.