Anesthesiology and pain management

• before – evaluates the patient in order to establish the necessary type of anesthetic and personal anesthetic risks and to adapt the anesthetic protocol to each particular case
• during – monitors the patient, modulates the anesthetic depending on the duration and complexity of the procedure and takes action in case of surgical complications
• after – monitors the patient during the first moments or hours after surgery, prevents and treats post-surgery complications

Dermatological surgical interventions are usually performed with local anesthesia which can be of two types, depending on the size of the excised lesion as well as on the type, duration and complexity of the procedure

– local anesthesia with Xilina (lidocaine)

– local anesthesia with EMLA cream

Local anesthesia with Xilina implies an injection administrated locally which can be initially felt as painful, yet any unpleasant sensation is soon abolished in that place.  It is the anesthesia of choice when it comes to surgical interventions with a scalpel or punch and suture. It is necessary that the patient is not allergic to Xilina.  A Xilina prick-test can be done prior to the procedure in order to certify the lack of allergy.

Local anesthesia with EMLA cream is the anesthesia of choice when it comes to CO2 laser procedures (resurfacing), Ellman radiofrequency procedures (ablation) and in the case of children and mucosal interventions and biopsies (genital, lips). The anesthetic cream is applied an hour prior to surgery for it to take effect; the advantages are that it presents no allergy risk for the patient and it does not involve any painful injection.

A dermatological intervention requires first of all a detailed explanation of the procedure by the specialist and the patient’s informed consent. On the day of the intervention the patient must come at the set time, having eaten, drunk their coffee and taken their daily treatment (should they be suffering from a chronic condition, the medication must not be interrupted unless advised otherwise by the surgeon or anesthesiologist)