Pediatric anesthesia in dermatologic surgery: When hand-holding is not enough

Background. Dermatologic procedures in children may require the use of topical and local anesthetics, sedatives, and general anesthesia. Objective. To review developments in topical and local anesthetics, sedatives, and general anesthesia relevant to dermatologic procedures in children. Methods. Review of the medical literature. Results. Topical anesthetics, including EMLA and liposome-encapsulated lidocaine cream, amethocaine, cetacaine, and benzocaine products may be useful for decreasing the pain of cutaneous procedures including intra-lesional lidocaine infiltration. A variety of sedative and hypnotic agents may be utilized for pediatric dermatology procedures, and guidelines for their appropriate use have been published. General anesthesia for dermatologic procedures in the pediatric population is appropriate for a variety of procedures including laser treatment of capillary malformations. Conclusion. A variety of anesthetic, analgesic, and sedatives may be useful for pediatric cutaneous surgery.