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Erschienen in: Current Dermatology Reports 3/2016

09.07.2016 | Medical Surgery (M Alam, Section Editor)

Premedication, Sedation, and Pain Medication in Dermatologic Surgery

verfasst von: Shali Zhang, Misha M. Heller, Grant R. Plost, Travis W. Blalock

Erschienen in: Current Dermatology Reports | Ausgabe 3/2016

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Abstract

Dermatologists and providers of dermatologic care perform a wide array of cutaneous procedures including biopsies, cryotherapy, curettage, excisions, flaps, grafts, chemical peels, ablative lasers, as well as many other invasive and non-invasive procedures. Patient management beyond the actual procedure continues to be an important aspect of patient care that impacts disease outcomes, patient outcomes, and patient satisfaction. With the potential morbidity involved with inadequate management of perioperative factors, a reminder of the need to be intentional and effective is necessary when it comes to the administration of antibiotics, pain control, and sedation. Here we discuss and review the selection and use of premedication, sedation, and pain medication when providing care for dermatologic surgery patients. We also discuss potential gaps regarding perioperative care and the ensuing research needs in this area.
Literatur
2.
Zurück zum Zitat Mangram AJ et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20(4):250–78. quiz 279-80.CrossRefPubMed Mangram AJ et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20(4):250–78. quiz 279-80.CrossRefPubMed
3.
Zurück zum Zitat Wright TI et al. Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008. J Am Acad Dermatol. 2008;59(3):464–73.CrossRefPubMed Wright TI et al. Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008. J Am Acad Dermatol. 2008;59(3):464–73.CrossRefPubMed
4.
Zurück zum Zitat Rossi AM, Mariwalla K. Prophylactic and empiric use of antibiotics in dermatologic surgery: a review of the literature and practical considerations. Dermatol Surg. 2012;38(12):1898–921.CrossRefPubMed Rossi AM, Mariwalla K. Prophylactic and empiric use of antibiotics in dermatologic surgery: a review of the literature and practical considerations. Dermatol Surg. 2012;38(12):1898–921.CrossRefPubMed
5.
Zurück zum Zitat Babcock MD, Grekin RC. Antibiotic use in dermatologic surgery. Dermatol Clin. 2003;21(2):337–48.CrossRefPubMed Babcock MD, Grekin RC. Antibiotic use in dermatologic surgery. Dermatol Clin. 2003;21(2):337–48.CrossRefPubMed
6.
Zurück zum Zitat Maragh SL et al. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg. 2005;31(1):83–91.CrossRefPubMed Maragh SL et al. Antibiotic prophylaxis in dermatologic surgery: updated guidelines. Dermatol Surg. 2005;31(1):83–91.CrossRefPubMed
7.
Zurück zum Zitat Hurst EA et al. Infectious complications and antibiotic use in dermatologic surgery. Semin Cutan Med Surg. 2007;26(1):47–53.CrossRefPubMed Hurst EA et al. Infectious complications and antibiotic use in dermatologic surgery. Semin Cutan Med Surg. 2007;26(1):47–53.CrossRefPubMed
8.
Zurück zum Zitat Dixon AJ et al. Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics. Dermatol Surg. 2006;32(6):819–26. discussion 826-7.PubMed Dixon AJ et al. Prospective study of wound infections in dermatologic surgery in the absence of prophylactic antibiotics. Dermatol Surg. 2006;32(6):819–26. discussion 826-7.PubMed
9.
Zurück zum Zitat Otley CC. Perioperative evaluation and management in dermatologic surgery. J Am Acad Dermatol. 2006;54(1):119–27.CrossRefPubMed Otley CC. Perioperative evaluation and management in dermatologic surgery. J Am Acad Dermatol. 2006;54(1):119–27.CrossRefPubMed
10.
Zurück zum Zitat Muller LM et al. Increased risk of infection in patients with diabetes mellitus type 1 or 2. Ned Tijdschr Geneeskd. 2006;150(10):549–53.PubMed Muller LM et al. Increased risk of infection in patients with diabetes mellitus type 1 or 2. Ned Tijdschr Geneeskd. 2006;150(10):549–53.PubMed
11.
Zurück zum Zitat Sabetta JB, Zitelli JA. The incidence of bacteremia during skin surgery. Arch Dermatol. 1987;123(2):213–5.CrossRefPubMed Sabetta JB, Zitelli JA. The incidence of bacteremia during skin surgery. Arch Dermatol. 1987;123(2):213–5.CrossRefPubMed
12.
Zurück zum Zitat Halpern AC et al. The incidence of bacteremia in skin surgery of the head and neck. J Am Acad Dermatol. 1988;19(1 Pt 1):112–6.CrossRefPubMed Halpern AC et al. The incidence of bacteremia in skin surgery of the head and neck. J Am Acad Dermatol. 1988;19(1 Pt 1):112–6.CrossRefPubMed
13.
Zurück zum Zitat Zack L et al. The incidence of bacteremia after skin surgery. J Infect Dis. 1989;159(1):148–50.CrossRefPubMed Zack L et al. The incidence of bacteremia after skin surgery. J Infect Dis. 1989;159(1):148–50.CrossRefPubMed
14.
Zurück zum Zitat Carmichael AJ et al. The occurrence of bacteraemia with skin surgery. Br J Dermatol. 1996;134(1):120–2.CrossRefPubMed Carmichael AJ et al. The occurrence of bacteraemia with skin surgery. Br J Dermatol. 1996;134(1):120–2.CrossRefPubMed
15.
Zurück zum Zitat Wilson WR, Rosenblatt JE, Washington 2nd JA. Anaerobic bacteremia. Conn Med. 1975;39(10):597–600.PubMed Wilson WR, Rosenblatt JE, Washington 2nd JA. Anaerobic bacteremia. Conn Med. 1975;39(10):597–600.PubMed
16.
Zurück zum Zitat Wilson W et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc. 2007;138(6):739–45. 747-60.CrossRefPubMed Wilson W et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc. 2007;138(6):739–45. 747-60.CrossRefPubMed
17.
Zurück zum Zitat Advisory statement. Antibiotic prophylaxis for dental patients with total joint replacements. American Dental Association; American Academy of Orthopaedic Surgeons. J Am Dent Assoc, 1997;128(7):1004-8. Advisory statement. Antibiotic prophylaxis for dental patients with total joint replacements. American Dental Association; American Academy of Orthopaedic Surgeons. J Am Dent Assoc, 1997;128(7):1004-8.
18.
Zurück zum Zitat American Dental Association; American Academy of Orthopaedic Surgeons. Antibiotic prophylaxis for dental patients with total joint replacements. J Am Dent Assoc. 2003;134(7):895–9.CrossRef American Dental Association; American Academy of Orthopaedic Surgeons. Antibiotic prophylaxis for dental patients with total joint replacements. J Am Dent Assoc. 2003;134(7):895–9.CrossRef
19.
Zurück zum Zitat Bae-Harboe YS, Liang CA. Perioperative antibiotic use of dermatologic surgeons in 2012. Dermatol Surg. 2013;39(11):1592–601.CrossRefPubMed Bae-Harboe YS, Liang CA. Perioperative antibiotic use of dermatologic surgeons in 2012. Dermatol Surg. 2013;39(11):1592–601.CrossRefPubMed
20.
Zurück zum Zitat Chen AF et al. Prediction of postoperative pain after Mohs micrographic surgery with 2 validated pain anxiety scales. Dermatol Surg. 2015;41(1):40–7.CrossRefPubMed Chen AF et al. Prediction of postoperative pain after Mohs micrographic surgery with 2 validated pain anxiety scales. Dermatol Surg. 2015;41(1):40–7.CrossRefPubMed
21.
Zurück zum Zitat Granot M, Ferber SG. The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study. Clin J Pain. 2005;21(5):439–45.CrossRefPubMed Granot M, Ferber SG. The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study. Clin J Pain. 2005;21(5):439–45.CrossRefPubMed
22.
Zurück zum Zitat Ravitskiy L et al. The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: conclusions from randomized controlled and prospective studies. J Am Acad Dermatol. 2011;64(2):310–22.CrossRefPubMed Ravitskiy L et al. The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: conclusions from randomized controlled and prospective studies. J Am Acad Dermatol. 2011;64(2):310–22.CrossRefPubMed
23.
Zurück zum Zitat Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia, in American Society of Anesthesiologists, ASA House of Delegates. 2014. Continuum of depth of sedation: definition of general anesthesia and levels of sedation/analgesia, in American Society of Anesthesiologists, ASA House of Delegates. 2014.
24.
Zurück zum Zitat Otley CC, Nguyen TH. Safe and effective conscious sedation administered by dermatologic surgeons. Arch Dermatol. 2000;136(11):1333–5.CrossRefPubMed Otley CC, Nguyen TH. Safe and effective conscious sedation administered by dermatologic surgeons. Arch Dermatol. 2000;136(11):1333–5.CrossRefPubMed
25.
Zurück zum Zitat Christian M et al. Conscious sedation in dermatologic surgery. J Am Acad Dermatol. 2001;44(4):665–70.CrossRefPubMed Christian M et al. Conscious sedation in dermatologic surgery. J Am Acad Dermatol. 2001;44(4):665–70.CrossRefPubMed
26.
Zurück zum Zitat Chen BK, Eichenfield LF. Pediatric anesthesia in dermatologic surgery: when hand-holding is not enough. Dermatol Surg. 2001;27(12):1010–8.PubMed Chen BK, Eichenfield LF. Pediatric anesthesia in dermatologic surgery: when hand-holding is not enough. Dermatol Surg. 2001;27(12):1010–8.PubMed
27.
Zurück zum Zitat Weber PJ, Weber M, Dzubow LM. Sedation for dermatologic surgery. J Am Acad Dermatol. 1989;20(5 Pt 1):815–26.CrossRefPubMed Weber PJ, Weber M, Dzubow LM. Sedation for dermatologic surgery. J Am Acad Dermatol. 1989;20(5 Pt 1):815–26.CrossRefPubMed
28.
Zurück zum Zitat Otley CC, Nguyen TH, Phillips PK. Anxiolysis with oral midazolam in pediatric patients undergoing dermatologic surgical procedures. J Am Acad Dermatol. 2001;45(1):105–8.CrossRefPubMed Otley CC, Nguyen TH, Phillips PK. Anxiolysis with oral midazolam in pediatric patients undergoing dermatologic surgical procedures. J Am Acad Dermatol. 2001;45(1):105–8.CrossRefPubMed
29.
Zurück zum Zitat Moody BR, Holds JB. Anesthesia for office-based oculoplastic surgery. Dermatol Surg. 2005;31(7 Pt 1):766–9.CrossRefPubMed Moody BR, Holds JB. Anesthesia for office-based oculoplastic surgery. Dermatol Surg. 2005;31(7 Pt 1):766–9.CrossRefPubMed
30.
Zurück zum Zitat Abeles G et al. The combined use of propofol and fentanyl for outpatient intravenous conscious sedation. Dermatol Surg. 1999;25(7):559–62.CrossRefPubMed Abeles G et al. The combined use of propofol and fentanyl for outpatient intravenous conscious sedation. Dermatol Surg. 1999;25(7):559–62.CrossRefPubMed
31.
Zurück zum Zitat Otley CC, Nguyen TH. Conscious sedation of pediatric patients with combination oral benzodiazepines and inhaled nitrous oxide. Dermatol Surg. 2000;26(11):1041–4.CrossRefPubMed Otley CC, Nguyen TH. Conscious sedation of pediatric patients with combination oral benzodiazepines and inhaled nitrous oxide. Dermatol Surg. 2000;26(11):1041–4.CrossRefPubMed
32.••
Zurück zum Zitat Glass JS et al. Acute pain management in dermatology: risk assessment and treatment. J Am Acad Dermatol. 2015;73(4):543–60. quiz 561-2. This review article discusses a topic uncommonly discussed in dermatology or dermatologic surgery. It renders practical tips for assessing a patient’s pain medication needs as well as the important task to select the most appropriate treatment pre- and postoperatively. Glass JS et al. Acute pain management in dermatology: risk assessment and treatment. J Am Acad Dermatol. 2015;73(4):543–60. quiz 561-2. This review article discusses a topic uncommonly discussed in dermatology or dermatologic surgery. It renders practical tips for assessing a patient’s pain medication needs as well as the important task to select the most appropriate treatment pre- and postoperatively.
33.
Zurück zum Zitat Bing J, McAuliffe MS, Lupton JR. Regional anesthesia with monitored anesthesia care for dermatologic laser surgery. Dermatol Clin. 2002;20(1):123–34.CrossRefPubMed Bing J, McAuliffe MS, Lupton JR. Regional anesthesia with monitored anesthesia care for dermatologic laser surgery. Dermatol Clin. 2002;20(1):123–34.CrossRefPubMed
34.
Zurück zum Zitat Abeles G et al. The use of conscious sedation for outpatient dermatologic surgical procedures. Dermatol Surg. 2000;26(2):121–6.CrossRefPubMed Abeles G et al. The use of conscious sedation for outpatient dermatologic surgical procedures. Dermatol Surg. 2000;26(2):121–6.CrossRefPubMed
35.
Zurück zum Zitat Pollock H et al. Conscious sedation/local anesthesia in the office-based surgical and procedural facility. Clin Plast Surg. 2013;40(3):383–8.CrossRefPubMed Pollock H et al. Conscious sedation/local anesthesia in the office-based surgical and procedural facility. Clin Plast Surg. 2013;40(3):383–8.CrossRefPubMed
36.
Zurück zum Zitat Meeks NM, Glass JS, Carroll BT. Acute pain management in dermatology: mechanisms and pathways. J Am Acad Dermatol. 2015;73(4):533–40. quiz 541-2.CrossRefPubMed Meeks NM, Glass JS, Carroll BT. Acute pain management in dermatology: mechanisms and pathways. J Am Acad Dermatol. 2015;73(4):533–40. quiz 541-2.CrossRefPubMed
37.
Zurück zum Zitat Hruza G. Dermatology. In: Bolognia JL, Jorrizo JL, Schaffer JV, editors. Anesthesia, vol. II. 3rd ed. Philadelphia: Elsevier Saunders; 2012. Hruza G. Dermatology. In: Bolognia JL, Jorrizo JL, Schaffer JV, editors. Anesthesia, vol. II. 3rd ed. Philadelphia: Elsevier Saunders; 2012.
38.
Zurück zum Zitat Firoz BF et al. An analysis of pain and analgesia after Mohs micrographic surgery. J Am Acad Dermatol. 2010;63(1):79–86.CrossRefPubMed Firoz BF et al. An analysis of pain and analgesia after Mohs micrographic surgery. J Am Acad Dermatol. 2010;63(1):79–86.CrossRefPubMed
39.
Zurück zum Zitat Sniezek PJ, Brodland DG, Zitelli JA. A randomized controlled trial comparing acetaminophen, acetaminophen and ibuprofen, and acetaminophen and codeine for postoperative pain relief after Mohs surgery and cutaneous reconstruction. Dermatol Surg. 2011;37(7):1007–13.CrossRefPubMed Sniezek PJ, Brodland DG, Zitelli JA. A randomized controlled trial comparing acetaminophen, acetaminophen and ibuprofen, and acetaminophen and codeine for postoperative pain relief after Mohs surgery and cutaneous reconstruction. Dermatol Surg. 2011;37(7):1007–13.CrossRefPubMed
40.
Zurück zum Zitat Imani F et al. The therapeutic use of analgesics in patients with liver cirrhosis: a literature review and evidence-based recommendations. Hepat Mon. 2014;14(10):e23539.CrossRefPubMedPubMedCentral Imani F et al. The therapeutic use of analgesics in patients with liver cirrhosis: a literature review and evidence-based recommendations. Hepat Mon. 2014;14(10):e23539.CrossRefPubMedPubMedCentral
41.
Zurück zum Zitat Dwyer JP, Jayasekera C, Nicoll A. Analgesia for the cirrhotic patient: a literature review and recommendations. J Gastroenterol Hepatol. 2014;29(7):1356–60.CrossRefPubMed Dwyer JP, Jayasekera C, Nicoll A. Analgesia for the cirrhotic patient: a literature review and recommendations. J Gastroenterol Hepatol. 2014;29(7):1356–60.CrossRefPubMed
42.
Zurück zum Zitat Bailey E, Worthington H, Coulthard P. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth, a Cochrane systematic review. Br Dent J. 2014;216(8):451–5.CrossRefPubMed Bailey E, Worthington H, Coulthard P. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth, a Cochrane systematic review. Br Dent J. 2014;216(8):451–5.CrossRefPubMed
43.
Zurück zum Zitat DH Solomon, M, UpToDate. Nonselective NSAIDs: overview of adverse effects. DE Furst, PL Romain, editors. Waltham, MA; 2015 DH Solomon, M, UpToDate. Nonselective NSAIDs: overview of adverse effects. DE Furst, PL Romain, editors. Waltham, MA; 2015
44.
Zurück zum Zitat Harris K et al. Opioid prescribing patterns after Mohs micrographic surgery and standard excision: a survey of American Society for Dermatologic Surgery members and a chart review at a single institution. Dermatol Surg. 2014;40(8):906–11.CrossRefPubMed Harris K et al. Opioid prescribing patterns after Mohs micrographic surgery and standard excision: a survey of American Society for Dermatologic Surgery members and a chart review at a single institution. Dermatol Surg. 2014;40(8):906–11.CrossRefPubMed
45.
Zurück zum Zitat Harris K et al. Opioid pain medication use after dermatologic surgery. JAMA Dermatology. 2013;149(3):317.CrossRefPubMed Harris K et al. Opioid pain medication use after dermatologic surgery. JAMA Dermatology. 2013;149(3):317.CrossRefPubMed
46.
Zurück zum Zitat Lee M et al. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.PubMed Lee M et al. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.PubMed
47.
Zurück zum Zitat Elvir-Lazo OL, White PF. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin. 2010;28(2):217–24.CrossRefPubMed Elvir-Lazo OL, White PF. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin. 2010;28(2):217–24.CrossRefPubMed
48.
Zurück zum Zitat Akan M et al. Ice application to minimize pain in the split-thickness skin graft donor site. Aesthetic Plast Surg. 2003;27(4):305–7.CrossRefPubMed Akan M et al. Ice application to minimize pain in the split-thickness skin graft donor site. Aesthetic Plast Surg. 2003;27(4):305–7.CrossRefPubMed
49.
Zurück zum Zitat Kostadinov ID et al. Experimental study on the role of 5-HT2 serotonin receptors in the mechanism of anti-inflammatory and antihyperalgesic action of antidepressant fluoxetine. Folia Med (Plovdiv). 2014;56(1):43–9. Kostadinov ID et al. Experimental study on the role of 5-HT2 serotonin receptors in the mechanism of anti-inflammatory and antihyperalgesic action of antidepressant fluoxetine. Folia Med (Plovdiv). 2014;56(1):43–9.
Metadaten
Titel
Premedication, Sedation, and Pain Medication in Dermatologic Surgery
verfasst von
Shali Zhang
Misha M. Heller
Grant R. Plost
Travis W. Blalock
Publikationsdatum
09.07.2016
Verlag
Springer US
Erschienen in
Current Dermatology Reports / Ausgabe 3/2016
Elektronische ISSN: 2162-4933
DOI
https://doi.org/10.1007/s13671-016-0148-3

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