Effect of Different Types of Anaesthesia Including Percutaneous Local Anaesthesia on Survival of Experimental Skin Flaps

Abstract

Local anaesthesia by epicutaneous application of the ketocaine solution A 2358 gave survival of experimental skin flaps in the guinea pig which corresponded on average to 71% of the total flap. The survival after pentobarbitone anaesthesia, general anaesthesia with ether, and infiltration of prilocaine without and with adrenalin varied between 41 and 53%. The difference in effect between percutaneous anaesthesia with A 2358 and the other procedures was statistically significant (p<0.001). Epicutaneous application of A 2358 followed by one of the other forms of anaesthesia gave a flap survival that did not differ from that following local anaesthesia with A 2358 alone, except when followed by injection of prilocaine with adrenalin. The improved survival after epicutaneously applied A 2358 is probably attributable to an effect on the peripheral vascular bed resulting in increasing blood supply and nutrition. It may be possible that A 2358, for example, could be used in man as a complement to other forms of anaesthesia to provide enhanced tissue survival in skin flaps.