caa a22 4500 475790979 CHVBK 20180406123710.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s004230000138 doi (NATIONALLICENCE)springer-10.1007/s004230000138 Subcutaneous infusion anesthesia with diluted mixtures of prilocain and ropivacain [Elektronische Daten] [Helmut Breuninger, Franz Schimek, Peter Heeg] Background: Local anesthesia often suffices for surgery on the outside of the body. In recent years, it has been found that such local anesthesia can be adequately carried out using large amounts of highly diluted anesthetic solutions. Methods: Using one or more common infusomats, we injected mixed anesthetic solutions slowly, painlessly, paravenously, and automatically via subcutaneous infusion anesthesia (SIA) into the subcutaneous layer in a large group of patients scheduled for surgery. The local anesthetics used were prilocaine and ropivacaine (Xylonest and Naropin); these were diluted with original Ringer's solution with epinephrine (1:1,000,000) in 500-ml bottles. The concentration of the mixture varied between 0.3% and 0.08% depending on the requirements of surgery. The needles used ranged from 30-gauge to 20-gauge needles, with a length of 1.5-10cm. The speed of injection varied between 30ml/h and 1500ml/h, depending on the location, the requirements of the surgery and the needle size. Volumes usually ranged from 2ml to 600ml depending on the concentrations used. The maximum dose was approximately 4mg/kg prilocaine and 2mg/kg ropivacaine. Patients: We used this technique in preparing for 5020 major and minor skin operations in 3270 patients ranging in age from 0.5years to 95years (mean age 54years). Microbiological tests of the infusion system were carried out. Patients were asked about their pain during anesthesia, operation, and postoperatively. Results: There were no complications from local anesthesia. The technique proved safe and comfortable even for children and very sensitive patients. The median duration of postoperative anesthesia was 5h (maximum 23h). Choosing the concentration, the needle, the needle position, the flow rate, and the volume requires some experience. Springer-Verlag, 2000 Slow infusion anesthesia Local anesthesia Tumescent anesthesia Ropivacaine Skin tumor operations Vein surgery Lymph-node dissection nationallicence Breuninger Helmut Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, D-72076 Tübingen, Germany, Germany aut Schimek Franz Department of Anesthesiology, University of Tübingen, Hoppe Seylerstr. 6, D-72076 Tübingen, Germany, Germany aut Heeg Peter Department of Hospital Infection Control, University of Tübingen, Calwerstr. 7, D-72076 Tübingen, Germany, Germany aut Langenbeck's Archives of Surgery Springer-Verlag 385/4(2000-07-01), 284-289 1435-2443 385:4<284 2000 385 423 https://doi.org/10.1007/s004230000138 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000138 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Breuninger Helmut Department of Dermatology, University of Tübingen, Liebermeisterstr. 25, D-72076 Tübingen, Germany, Germany aut NATIONALLICENCE 700 1- Schimek Franz Department of Anesthesiology, University of Tübingen, Hoppe Seylerstr. 6, D-72076 Tübingen, Germany, Germany aut NATIONALLICENCE 700 1- Heeg Peter Department of Hospital Infection Control, University of Tübingen, Calwerstr. 7, D-72076 Tübingen, Germany, Germany aut NATIONALLICENCE 773 0- Langenbeck's Archives of Surgery Springer-Verlag 385/4(2000-07-01), 284-289 1435-2443 385:4<284 2000 385 423 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer