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Journal of the American Academy of Dermatology
Volume 74, n° 6
pages 1201-1219 (juin 2016)
Doi : 10.1016/j.jaad.2016.01.022
accepted : 15 January 2016
From the Academy

Guidelines for the use of local anesthesia in office-based dermatologic surgery

Work Group:David J. Kouba, MD, PhD a : Chair, Matteo C. LoPiccolo, MD a, b, c, Murad Alam, MD d, Jeremy S. Bordeaux, MD, MPH e, Bernard Cohen, MD f, C. William Hanke, MD g, Nathaniel Jellinek, MD h, Howard I. Maibach, MD i, Jonathan W. Tanner, MD, PhD j, Neelam Vashi, MD k, Kenneth G. Gross, MD l, Trudy Adamson, MSN, RN, DNC m, Wendy Smith Begolka, MBS n, Jose V. Moyano, PhD n,
a Toledo Clinic Facial Plastics and Dermatology, Toledo, Ohio 
b Department of Dermatology, Henry Ford Health System, Detroit, Michigan 
c Dermatology Specialists of Shelby, Shelby, Michigan 
d Department of Dermatology, Northwestern Memorial Hospital, Chicago, Illinois 
e Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio 
f Department of Dermatology-Pediatrics, Johns Hopkins Children's Center, Baltimore, Maryland 
g Laser and Skin Surgery Center of Indiana PC, Carmel, Indiana 
h Department of Dermatology, Brown University, East Greenwich, Rhode Island 
i Department of Dermatology, UCSF School of Medicine, San Francisco, California 
j Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania 
k Department of Dermatology and Center for Ethnic Skin, Boston University School of Medicine, Boston, Massachusetts 
l Skin Surgery Medical Group, Inc, San Diego, California 
m Department of Nursing, Mayo Clinic College of Medicine, Rochester, Minnesota 
n Department of Science, Quality and Practice, American Academy of Dermatology, Schaumburg, Illinois 

Reprint requests: Jose V. Moyano, PhD, 930 E Woodfield Rd, Schaumburg, IL 60173.930 E Woodfield RdSchaumburgIL60173

There are an increasing number and variety of dermatologic surgical procedures performed safely in the office setting. This evidence-based guideline addresses important clinical questions that arise regarding the use and safety of local anesthesia for dermatologic office-based procedures. In addition to recommendations for dermatologists, this guideline also takes into account patient preferences while optimizing their safety and quality of care. The clinical recommendations presented here are based on the best evidence available as well as expert opinion.

The full text of this article is available in PDF format.

Key words : anesthesia, clinical guideline, dermatology, education, epinephrine, infiltration, local anesthesia, local nerve block, office-based surgery, pain, safety, topical, tumescent

 Funding sources: None.
 This guideline was developed in accordance with the Academy's Administrative Regulations for Evidence-Based Guidelines, and followed a strong disclosure and conflict of interest management plan consistent with Institute of Medicine and Council of Medical Specialty Society standards. The authors' conflict of interest disclosure statements appear at the end of this article.

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