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Anaesthesia General 013b0c41

A man presented with cut wound over scalp. The best anaesthetic agent for wound repair is:

A
1% xylocaine
B
2% xylocaine
C
Ketamine
D
Xylocaine + adrenaline
High-Yield Explanation
In clinical practice, a vasoconstrictor, usually epinephrine, is often added to local anesthetics. The vasoconstrictor performs a dual service. By decreasing the rate of absorption, it not only localizes the anesthetic at the desired site, but also allows the rate at which it is destroyed in the body to keep pace with the rate at which it is absorbed into the circulation. This reduces its systemic toxicity. Must Know: The use of vasoconstrictors in local anesthetic preparations for anatomical regions with limited collateral circulation could produce irreversible hypoxic damage, tissue necrosis, and gangrene, and therefore is contraindicated. Ref: Catterall W.A., Mackie K. (2011). Chapter 20. Local Anesthetics. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

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