KEY TAKEAWAYS
- The study aimed to investigate the efficacy of tumescent local anesthesia for skin cancer surgery in the elderly, focusing on clinical benefits and postoperative complication risk.
- Researchers noticed significant efficacy of tumescent local anesthesia in skin cancer surgery for elderly patients, optimizing treatment processes and minimizing anesthesiologic risks.
Dermatosurgery in elderly individuals, owing to frailty, often necessitates tumescent local anesthesia, yet data on its efficacy remains scarce.
Saskia Maria Schnabl and the team aimed to assess the efficacy of tumescent local anesthesia in skin cancer surgery among the elderly, focusing on clinical benefits such as treatment processes and pain management, alongside evaluating local postoperative complication risks.
Researchers performed an inclusive analysis of patients aged 75 years and older undergoing inpatient head and neck skin cancer surgery under tumescent local anesthesia.
About 2,940 procedures were conducted in 782 patients (mean age 83.3 years), aimed at achieving complete tumor resection during their inpatient stay. On average, 3.8 (range: 1-20) interventions were performed over 4.9 days (range: 1-28). Approximately 43.2% of patients did not require postoperative analgesia, while 53.5% received NSAIDs and 3.3% received opioids.
The most common local postoperative complication was infection, occurring in 13.6% of cases. Surgical intervention due to bleeding was required in 2.8% of cases, none of which were hemoglobin-relevant or life-threatening. Suture dehiscence and necrosis were rare, occurring in only 0.6% of cases.
The study concluded that tumescent local anesthesia is an effective method for skin cancer surgery in the elderly. This optimizes treatment processes, minimizes anesthesiologic risks, and results in low and treatable local postoperative complications. Additionally, its long-lasting analgesia reduces the need for analgesics and minimizes drug interactions.
The study was sponsored by Projekt DEAL.
Source: https://pubmed.ncbi.nlm.nih.gov/38243888/
Schnabl SM, Garbe C, Breuninger H, et al. (2024). “Tumescent local anesthesia in geriatric patients with head and neck skin cancer – a retrospective study of 782 patients.” J Dtsch Dermatol Ges. 2024 Feb;22(2):210-221. doi: 10.1111/ddg.15287. Epub 2024 Jan 20. PMID: 38243888.
