Bilevel anesthesia and blunt dissection: Rapid and safe surgery

Background. A new concept of bilevel anesthesia, initially instilling a sub cutaneous tumescent solution followed by surface anesthesia, and then disse ction limited to blunt instrumentation has been developed. Objective. The purpose of these developments has been to evolve more rapid and safe surgical intervention. Methods. This work has included a wide variety of surgeries on patients ove r several years, including grafts, flaps, and hair transplantation. Results. Excellent anesthesia with virtually bloodless surgical fields has followed the adoption of bilevel anesthesia with blunt dissection practices . Conclusion. Adoption of the previously described tumescent anesthetic infil tration with blunt dissection principles combined now with stronger epiderm al-dermal anesthetic and epinephrine solutions allows the safest and most r apid surgery described to date.