A randomized, double-blind comparison of the total dose of 1.0% lidocaine with 1: 100,000 epinephrine versus 0.5% lidocaine with 1:200,000 epinephrine required for effective local anesthesia during Mohs micrographic surgery for skin cancers

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10 Scopus citations

Abstract

Objective: We sought to compare total lidocaine dose and patient comfort when using 1.0% lidocaine with 1:100,000 epinephrine versus 0.5% lidocaine with 1:200,000 epinephrine during Mohs micrographic surgery. Methods: In all, 149 patients were randomized to receive 1.0% lidocaine with 1:100,000 epinephrine or 0.5% lidocaine with 1:200,000 epinephrine during Mohs micrographic surgery. The total dose of lidocaine and measures of patient comfort were recorded. Results: Compared with the 1.0% lidocaine group, there was a 52% reduction in lidocaine dose in the 0.5% group (mean difference, 147.85 mg; 95% confidence interval, 108.15-187.55; P < .001). Patient comfort was equivalent in both groups, as evidenced by the similar mean visual analog scale scores (P = .48) and mean volumes of rescue lidocaine administered (P = .18). Limitations: No lidocaine blood levels were measured, and one Mohs surgeon performed all surgeries. Conclusion: The dose of 0.5% lidocaine with 1:200,000 epinephrine provides pain control equivalent to 1.0% lidocaine with 1:100,000 epinephrine at approximately half the total lidocaine dose.

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ASJC Scopus subject areas

  • Medicine(all)
  • Dermatology

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A randomized, double-blind comparison of the total dose of 1.0% lidocaine with 1 : 100,000 epinephrine versus 0.5% lidocaine with 1:200,000 epinephrine required for effective local anesthesia during Mohs micrographic surgery for skin cancers. / Morganroth, Pamela A.; Gelfand, Joel M.; Jambusaria, Anokhi; Margolis, David J.; Miller, Christopher J.

In: Journal of the American Academy of Dermatology, Vol. 60, No. 3, 03.2009, p. 444-452.

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