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The short answer is that epinephrine is not necessary for local anesthesia. However, there are two reasons that it is extremely beneficial. It helps control bleeding and it allows the numbing to last longer. Make sure to discuss the reasons you would like to avoid epinephrine with your doctor. I have treated scalp lesions without epinephrine but it always takes a little longer and it is sometimes more difficult to keep the area completely numb. True epinephrine allergies are extremely rare since it is a chemical that the body makes naturally and that is required for normal body functioning.
The use of lidocaine with Epi during Mohs surgery is optimal, especially in areas where bleeding can be excessive (like the scalp) because the epinephrine causes vasoconstriction and minimizes bleeding. It is very advantageous to minimize bleeding as it allows the surgeon to see more clearly and be able to cut and suture in a more meticulous way. Some patients are sensitive to the Epi and it can make them feel like their heart is racing, however, the small amount that is used in Mohs surgery is not typically problematic and contributes greatly to a smooth and uneventful surgery.
Thanks for your question. The epinephrine in local anesthesia acts to 1) stop bleeding 2) reduce diffusion of the lidocaine. Most surgeons prefer to use epinephrine in the scalp because the scalp is highly vascular. Anything is possible, but I would discuss this question with your surgeon before you start Mohs. Best of luck.
Hello!Thank you for your question. More than likely, your Mohs surgeon will apply a large pressure dressing to your surgical site that should be sufficient to minimize bleeding/bruising while you are making your way to the plastic surgeon for repair. The forehead is an area that can result in...
Basal cell carcinoma with squamous differentiation could mean several things and this has been the subject of some debate. It could mean separate tumors, one basal cell carcinoma and the other, squamous lying so close that the elements of each collide. This is called a collision tumor. The...
For lower lip wounds like yours, I have my patients clean the wound twice daily with sterile normal saline to prevent buildup and solidifying of all yellowish exude. They are then directed to apply just Vaseline to the wound to keep it moist . Topical antibiotics should be avoided. A non-stick...
Hello,Thank you for your question! Some burning and tingling is to be expected following Mohs surgery. Sometimes it can be the result of irritation due to antibiotic ointment or adhesive from the bandage. If the burning and tingling is associated with severe pain, redness, or swelling, it could ...
Hard to say what type of closure was performed without a photograph. There are a number of reconstructive options in this area to minimize pull on the eyelid/eyebrow. If it's a straight or slightly curved line, then it's likely a linear closure. If there's a horizontal and vertical line, then...
Moh’s surgery on the face often requires surgical repair and reconstruction to reapproximate the skin edges. Flaps or direct closure techniques are used. It is important that you optimize scar healing during this phase in order to reduce longterm scars. For red scars, we use Vbeam laser, f...