Tumescent infiltration versus femoral nerve block for skin graft harvest-a prospective randomized study

ABSTRACT

In this prospective, randomized study, 60 patients requiring a single sheet of graft were randomized into 2 groups. Tumescent infiltration was used for anesthesia in one group and femoral nerve block in the other. The pain during administration of anesthesia, the time required for onset of action, the pain during graft harvest and the failure rates were recorded. Statistical comparison was done using Fischers Exact probability test for the failure rates and Mann Whitney- U test for the other parameters. The pain during administration was significantly higher for tumescent infiltration. The time for onset of action was significantly faster with femoral nerve block. The pain during harvest and the failure rates did not show any significant difference. We conclude that tumescent infiltration is more painful than femoral nerve block but equally effective as anesthesia with no difference in the failure and complication rates.

KEYWORDS

Tumescent - Femoral nerve block - Skin graft

• 1 McGregor IA, McGregor AD.. Free skin grafts. In: McGregor AD. editor Fundamental principles of plastic surgery and their clinical applications.. 10th. edn London:Harcourt publishers; 2000: p.42
• 2 Calgary regional health authority [Home page on internet]. Canada:Arraf J, C 2004 [updated 2004 April 14;cited 2005 May 27]. Femoral nerve blocks - Anatomy, technique, considerations, applications;[about two screens].. Available from http://www.calgaryhealthregion.ca/clin/anaesth/Regional/Workshop10/femoraln.htm
• 3 Klein JA. Tumescent technique for regional anesthesia permits lidocaine doses of 35mg/kg for liposuction. Dermatol surg oncol 1990; 16: 248-63
• 43 Agarwal P.. Safe method for release of severe post burn neck contracture under tumescent local anesthesia and ketamine. Indian J Plast surg 2004; 37: 51-4
• 4 Bussolin L, Busoni P, Giorgi L, Crescioli M, Messeri A. Tumescent local anesthesia for the surgical treatment of burns and post burn sequelae in pediatric patients. Anesthesiology 2003; 99: 1371-5
• 6 Khan ML, Hossain MM, Chowdhari AY, Saleh QA, Majid MA. Lateral femoral cutaneous nerve block for split skin grafting. 1998; 24: 32-4
• 7 Khoo ST, Brown SYT. Femoral nerve block - The anatomical basis for a single injection technique. Anesthesia and Intensive care 1983; 11: 40-2
• 8 Breivik EK, Bjornson GA, Skovlund E.. A comparison of pain rating scales by sampling from clinical trial data. Clinical journal of pain 2000; 16: 22- 8