Local anesthetic infiltration vs. nervous blocks in face’s skin lesions: what’s new

Skin tumors are the most common type of cancer. They are localized throughout the body, more frequently in those regions chronically exposed to sun, like face, scalp and neck, compromising aesthetic appearance. The optimization of day hospital surgical procedures is mandatory, to avoid erroneous indications, insufficient intra operative comfort and prolonged recovery. New guidelines should be discussed and shared. Patients were divided in two groups: i. Group A of 50 patients, 21 male and 29 female, age 65 ±9, ASA I – III (10/19/21), weight 68±11 kg, height 160±8, with anesthetic Local Infiltration (LI); ii. Group B of 50 patients, 16 male, 34 female, age 68 ±10, ASA I – III (9/22/19), weight 64 ± 9 kg, height 158 ±11, with nerve block (NB). The purpose of our study is to evaluate the analgesia level, compliance and complication rate after LI or selective NB with alkalinised mepivacaine cloridrate 2%, Guardant®. Demographic data, ASA physical stauts, size of lesions, surgery, anesthesia durations and volume of LA injected were analyzed. Fisher’s exact test and Student’s t test were used; P ≤ 0.05 was considered statistically significant. No differences in age (65 ± 9 vs 68 ± 10 years), weight (68 ± 11 vs 64 ± 9), height (160 ± 8 vs 158 ± 11 cm), size of lesion (23 ± 11 vs 25 ± 14 mm), duration of surgery (47 ± 18 vs 51 ± 23 minutes) were detected in two groups (p > 0.05). Both anesthetic techniques ensured good analgesia, but only nerve’s blocks were be able to determine satisfactory intra operative patient’s comfort, a bloodless wound and weak risk for nervous lesions and toxic reaction to local anesthetic.