Plastic Surgery>>>>>Basic principles and basic science
Question 56#

The following statement is incorrect regarding local anaesthetic administration:

a. The maximum dose for lignocaine infiltration is 4mg/kg
b. The maximum dose for lignocaine + adrenaline (epinephrine) infiltration is 7mg/kg
c. Warming the solution may reduce the pain of administration
d. Rate of subcutaneous injection rarely influences the perception of pain by the patient
e. Adding hyaluronidase is a useful technique for the harvesting of split thickness skin grafts

Correct Answer is D

Comment:

Rate of subcutaneous injection rarely influences the perception of pain by the patient. This statement is incorrect; increasing the rate of subcutaneous injection increases the pain. Warming and alkalinising the anaesthetic with bicarbonate also reduces the pain of infiltration. Although the ‘safe’ dose of lidocaine for direct infiltration is 4 or 7mg/kg with or without adrenaline (epinephrine), respectively, it can safely be used in much higher concentrations such as during tumescent infiltration for liposuction.