Local anaesthesia in dermatology — SAQ

Stem

You are about to perform a 6 mm punch biopsy on the back of a 70 kg adult and later a larger ellipse on the same list. The stock solution is 1% lidocaine with epinephrine.

Questions

a) Convert 1% lidocaine to mg/mL and calculate the classical maximum milligram dose with epinephrine for this adult (state the mg/kg figure you use). (3 marks)

b) List four practical measures that reduce injection pain. (2 marks)

c) Name three early symptoms of local anaesthetic systemic toxicity and the first three management priorities. (3 marks)

d) Briefly explain how tumescent anaesthesia differs conceptually from standard infiltrative dosing for a small punch. (2 marks)