Local anesthesia in thoracic surgery: 20 years experience with 3265 cases.
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The effect of local anesthesia with ethyl chloride freezing on biopsy size and quality for microscopy was studied postmortem. Four-mm punch biopsies were taken from the abdominal skin by different techniques: manual punch and drill (250 RPM) at 8 degrees C and 33 to 36 degrees C, ethyl chloride, and injection of lidocaine for local anesthesia. Histologic sections were assessed, and defatted dried weight (DW) was determined as an expression of biopsy size. After ethyl chloride freezing, microscopy showed more trauma (p less than 0.001) and characteristic, marginal tissue-breaks (p less than 0.01). More biopsies (p less than 0.05) were not proper for microscopy. DW and the variances showed no differences. It is concluded that local anesthesia with ethyl chloride freezing results in tissue trauma and inferior quality of the tissue specimens for microscopy.
In a prospective randomized study of 99 displaced Colles' fractures, regional intravenous block was compared with local anesthesia in the fracture hematoma. Patients treated with regional intravenous block had less pain during the manipulation of the fracture and better grip strength at the 6-month follow-up. The anatomic end result (dorsal angulation) was better after regional anesthesia.
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