Not just tachycardia: A pilot study examining wound‑healing complications associated with the dose and volume of lignocaine in skin cancer excisions.

Background and objectives: General practitioners excise many suspected skin cancers using local anaesthetics such as lignocaine, but the relationships between the dose and volume of the local anaesthetic and wound complications are unclear. This pilot study considers an association between the dose and volume and complications.

Method: An audit was conducted of patient records from two time periods: one before and one after an education intervention. Data extracted included lignocaine (volume and dose), wound complications (dehiscence and infection) and the demographics of patients and clinicians.

Results: Both the dose and volume of lignocaine administered were significantly associated with complication rates (P=0.0084 and P=0.0209, respectively). In the post-intervention period, clinician behaviour changed, with a reduction in the volume and dose of lignocaine administered (P<0.001 and P<0.001, respectively) without episodes of inadequate analgesia.

Discussion: This pilot study reported a relationship between lidocaine dose and volume and rates of complications. Shortcomings of this study limit attribution of findings to clinical practice. However, the results justify further rigorous research.