Potentially breaching the toxic limit of local anaesthetic in day case breast surgery

Introduction: Wire-guided excisions (WGE) of breast tissue involves the insertion of a titanium wire under image guidance prior to surgery enabling localisation and removal of lesions. Three discrete clinical encounters require local anaesthesia (LA); wire insertion in radiology, regional anaesthetic blocks after induction and surgical closure. An initial audit showed that 79% of patients over an eleven-week period received a combined dose of LA that was above the maximum dosage in guidelines. Our aim was to re-audit our findings of LA used in WGE post-intervention.