L M Field1. 1. Department of Dermatology, Dermatologic Surgery, University of California, San Francisco, California, USA. lmfieldmd@aol.com
Abstract
BACKGROUND: A new concept of bilevel anesthesia, initially instilling a subcutaneous tumescent solution followed by surface anesthesia, and then dissection limited to blunt instrumentation has been developed. OBJECTIVE: The purpose of these developments has been to evolve more rapid and safe surgical intervention. METHODS: This work has included a wide variety of surgeries on patients over several years, including grafts, flaps, and hair transplantation. RESULTS: Excellent anesthesia with virtually bloodless surgical fields has followed the adoption of bilevel anesthesia with blunt dissection practices. CONCLUSION: Adoption of the previously described tumescent anesthetic infiltration with blunt dissection principles combined now with stronger epidermal-dermal anesthetic and epinephrine solutions allows the safest and most rapid surgery described to date.
BACKGROUND: A new concept of bilevel anesthesia, initially instilling a subcutaneous tumescent solution followed by surface anesthesia, and then dissection limited to blunt instrumentation has been developed. OBJECTIVE: The purpose of these developments has been to evolve more rapid and safe surgical intervention. METHODS: This work has included a wide variety of surgeries on patients over several years, including grafts, flaps, and hair transplantation. RESULTS: Excellent anesthesia with virtually bloodless surgical fields has followed the adoption of bilevel anesthesia with blunt dissection practices. CONCLUSION: Adoption of the previously described tumescent anesthetic infiltration with blunt dissection principles combined now with stronger epidermal-dermal anesthetic and epinephrine solutions allows the safest and most rapid surgery described to date.