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2 0.15 (1:1000)

"Solution 1 makes a "sting-free" local anesthetic with 0.5% lidocaine. Solution 2 is "sting free" with 0.5% lidocaine and 1:200,000 epinephrine. These preparations should be mixed daily and discarded at the end of the day. The total volume of each mix is 30 mL.

"Solution 1 makes a "sting-free" local anesthetic with 0.5% lidocaine. Solution 2 is "sting free" with 0.5% lidocaine and 1:200,000 epinephrine. These preparations should be mixed daily and discarded at the end of the day. The total volume of each mix is 30 mL.

invasive procedures. I use a combination of intravenous midazolam (Versed, Roche; Manati, PR) and fentanyl (Sublimase, Abbott Labs; Chicago). To decrease anxiety and diminish the discomfort associated with positioning, it may be helpful to begin these medications before the patient is placed on the operating table. Dosages are chosen according to patient size and medical condition. The final amount is determined with titration while observing the patient's response.

General anesthesia is rarely needed for PV, but it is used occasionally for patients in extreme pain who cannot tolerate the prone position used in PV or for patients with psychological restrictions that preclude a conscious procedure. It is not needed for routine PV and should be avoided when possible because it adds a mild risk and considerable cost to the procedure. As described earlier, Barr et al.44 used general anesthesia routinely with CT-guided procedures to ensure minimum patient motion.

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