Community Views: Anesthesia
We recently published an article detailing one advocate's experiences with anesthesia, and its use during skin cancer surgeries and related procedures (which you can read here). Many of our community members chimed in with their own experiences with anesthesia for skin cancer. Below is what they had to say.
There are pros and cons to local anesthesia. One huge con is being awake during a very scary procedure like Mohs. However, some advantages include a low impact on a patient's health and safety, a lower risk of complications, and being often less costly compared to general anesthesia.1 It's important for patients to be mentally prepared for their upcoming procedure, so do your research, speak up, and ask all the questions you need!
Experiences with local anesthesia
"Over 150 short and long needle lidocaine injections in 3 waves in my thigh to do a Mohs surgery...still felt pain, tugging. Lidocaine for debridement didn't help at all. Wish I could have been put to sleep for the Mohs."
"All I know is the lidocaine burns like fire and I go through it quickly which means more jabs."
"I honestly don't remember how many lidocaine shots I had... more than 30, I think. Couldn't feel anything, but I could hear it...the cutting. And smell it...the cauterizing."
"Hurts like hell in your nose, not so bad in the arm. Didn't feel real good behind my ear for a skin graft."
"I don’t know how many shots of lidocaine I had, but my teeth were numb and I was shaky."
Sedation, which typically involves pain pills or sedatives, is occasionally used in order to calm a patient right before a procedure with local anesthesia. After a sedative is given, people usually feel a bit drowsy, but notice a huge reduction in anxiety and stress. Some community members asked their doctor for a prescription to calm their nerves before a big skin cancer surgery.
Experience with sedation
"I’ve had 24 excisions done over the past 14 months... The best thing I’ve done for myself is asking my primary care doctor for a prescription for Valium to be taken 30-40 minutes pre-op. The dosage is only 2mg, but it’s enough to just take the edge off and makes the procedures so much easier to handle. (I did double up for the Mohs and melanoma procedures as they were much more involved)."
Although not many members shared an experience with general anesthesia while undergoing skin cancer surgery, it is sometimes an option. For example, if the lymph nodes are enlarged near a diagnosed skin cancer spot, a lymph node dissection might be done which usually requires general anesthesia. Similarly, depending on the size and location of the lesion, general anesthesia may be used for surgical excision and reconstruction.2
What does red hair have to do with anything?
Did you know that redheads, or those born with red hair, are harder to sedate? According to Dr. Shalini Shah, a pain management specialist at UCI Health in California, “Classic anesthesia literature has documented that redheads require more anesthesia.” UCI Health reports that redheads need about 20% more anesthesia to be sedated and also need more local topical anesthetics, like Novocain or lidocaine.
"Glad the ‘red hair gene’ was mentioned. A lot of doctors and most dentists are not aware us redheads require about 20% more anesthetic to achieve the same pain-free experience that ‘normal’ folks do!"
How well was your skin cancer diagnosis explained to you?