Introduction:

Mohs micrographic surgery is used for the excision of malignant skin tumors and often is followed by reconstruction, prolonging the procedure, causing anxiety and discomfort to the patient. Mohs surgery is performed with local anesthesia and complementary sedation. Among the intravenous anesthetics, Dexmedetomidine is an excellent option; however, there have been reports of severe bradycardia associated with hemodynamic instability and risk of complications with its use.

Objective:

To describe the frequency of bradycardia with hemodynamic repercussion in patients undergoing Mohs micrographic surgery plus reconstruction, under loco regional anesthesia and Dexmedetomidine sedation.

Methods:

A retrospective, descriptive, observational study of 30 patients undergoing Mohs surgery between November 1, 2012 and November 30, 2013.

Results:

53.3% were women, the average age was 68.4 years, 21.4% were classified as ASA I, 53.5% ASA II and 25% ASA III. The average surgical time was 184 ± 61 minutes and anesthesia with dexmedetomidine was 196 ± 65.2 minutes. Only one patient required atropine during surgery and no patient required conversion to general anesthesia.

Conclusion:

Dexmetomidine is an appropriate alternative to provide sedation in patients undergoing Mohs surgery under loco-regional anesthesia, due to its low incidence of bradycardia with hemodynamic repercussion and absence of the need for ventilatory support.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )