What is the role of anesthesia in the performance of temporal artery biopsy?

Updated: Sep 04, 2018
  • Author: Andrew A Winkler, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

See the list below:

  • Temporal artery biopsy can be performed in a minor procedure suite or in the operating room, with or without the aid of an anesthesiologist. Most clinicians agree that the procedure can be safely performed with local anesthesia alone. If a patient is unable to tolerate the procedure with only local anesthesia, IV sedation with the help of a trained anesthesia provider may be necessary.

  • The author's preferred method of anesthesia for temporal artery biopsy is using only local anesthesia. A 1:1 mixture of lidocaine 1% with 1:200,000 epinephrine and bupivacaine 0.5% with 1:200,000 epinephrine buffered with 8.4 % sodium bicarbonate provides good short-term and long-term anesthesia. To ensure that the entire area is anesthetized, perform a ring block with a 3-cm radius from the incision site. The ring block should be performed after marking the incision and the path of the superficial temporal artery, as epinephrine will cause arterial spasm. For more information, see Local Anesthetic Agents, Infiltrative Administration.

  • A useful adjunct is to apply a topical anesthetic cream 20 minutes prior to injecting lidocaine. [10] Though certainly not necessary, topical anesthesia can make the experience more comfortable for the anxious patient. The patient need not be marked prior to applying topical anesthesia. For more information, see Anesthesia, Topical.

  • The video below demonstrates the local anesthesia for this procedure.

    Local anesthesia.

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