๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Anesthesia for melanoma surgical procedures
Anesthesia for melanoma surgical procedures
Surgical excision is the mainstay of curative therapy for early-stage melanoma, and
provides local control of the primary lesion. Initial treatment involves WLE, with possible SLNB or lymph node dissection. The choice of anesthetic is predicated on the size and location of the planned excision, as well as the need for node sampling. In general, WLE alone can be accomplished with local anesthesia, or, for more involved excisions, conscious sedation under monitored anesthesia care (MAC). Lymph node dissection of the neck, axilla, groin, or iliac basins requires more extensive incisions and tissue manipulation, and should be performed under general anesthetic. For patients requiring general anesthesia, preoperative clearance based on consensus guidelines from the American College of Cardiology and American Heart Association should be performed.17
For local anesthesia, many options are available, and a mix of short- and long-acting anesthetics (1% lidocaine mixed 50:50 with 0.5% bupivacaine and epinephrine) may provide faster onset and longer duration of action. A ring block may be useful as well. Once the superficial layers have been infiltrated, the subcutaneous space may be infiltrated as well.