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Does General Anesthesia Help to Avoid Using So Much Lidocaine?

asked 2 years ago by new-me in south
Latest answer by Francisco Canales, MD
Question viewed 615 times
Tags: anesthesia

I need lipo in several areas but keep hearing about lido poison. Is there any way to avoid using so much lido so you can do more areas. Does it matter what kind of anesthesia you use in relation to how much lido is used? Thanks

13 answers to Does General Anesthesia Help to Avoid Using So Much Lidocaine?

Lidocaine toxicity and general anesthesia vs local anesthesia

The amount of lidocaine in the bloodstream is usually the dangerous factor. This can be minimized by calculating the weight of the patient, the amount of local anesthetic given, and the amount of epinephrine used (which delays the absorption of the lidocaine, making it safer). Whether under local anesthesia, IV sedation or light general anesthesia, we prefer to have a board certified anesthesiologist there to monitor the safety of the patient in all significant liposuction cases. It is... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Every medicine is a poison. It is just a matter of dose.

It is possible to have enough lidocaine as to be poisoned by it. But this is also true if you have too much tylenol or aspirin. What makes a drug safe is the difference between the dose needed to be effective and the dose that is associated with toxicity. There is no question the safest form of liposuction is pure tumescent liposuction using only lidocaine local anesthesia and holding the dose at or bellow a total dose of 35 mg/kg. The patient is awake for the procedure perhaps having... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Lidocaine dosage can be calculated ahead of time before liposuction.

Your surgeon will have a good idea of how much fat will be removed from the areas you are considering. You can do significantly more liposuction under general anesthesia than under local anesthesia. It is simply a matter of dosage. We use a lot less lidocaine in a liter of tumescent solution when the patient is asleep. Liposuction can be done awake, but the goals have to be more modest since we have a limit on how much lidocaine can be used to keep you comfortable. more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

LIDOCAINE TOXICITY AND LIPOSUCTION

The current recommendation by the American Society of Plastic Surgeons is to limit the TOTAL amount of lidocaine for liposuction to 35mg/kg. This means for a 70 kg person (154 pounds), the total amount of lidocaine should be 2450 mg, which typically means 2-3 liters of fluid (depending on how dilute the lidocaine is in the bag). If you have chosen to have your liposuction done without any intravenous sedation or general anesthesia, then the amount of lidocaine given has... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Genral Anesthesia vs Local Anesthesia

Absolutely. In lipo cases under general anesthesia many surgeons use lidocaine in their tumescent solution with the idea that you will have more pain control post op. All competent surgeons will be acutely aware of how much lidocaine you are receiving during the case to avoid lidocaine toxicity. If you are in the zone of having to give too much lido you can merely dilute the solution more. I personally do not believe in massive lipo so I never go any where near those levels. Some... more

Clayton L. Moliver, MD
Houston Plastic Surgeon

Lidocaine Toxicity - Liposuction under General Anesthesia VS Awake / Tumescent Anesthesia

Lidocaine, like all drugs, is a double edged tool. It is a wonderful drug that relieves pain and can stop certain heart rhythm abnormalities but in higher dosages it can be fatal. With the tumescent solution we use in Liposuction, we infuse large amounts of dilute Lidocaine into the fat. The larger the amount of lidocaine used, the closer we reach the threshold of lidocaine toxicity and serious side effects. So WHEN to use awake Tumescent Liposuction and when to use Tumescent solution... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

General anesthesia and liposuction

General anesthesia allows the surgeon to work on more areas that would not be sufficiently numb if only tumescent anesthetic were used because the latter has a limit to how much lidocaine is used. This limit is based on the patient's weight, age and medication (prescription and over-the-counter) that is taken regularly that can affect the liver's metabolism of the lidocaine. However, removing too much fat, under general anesthesia without tumescent lidocaine can increase the risk of more... more

Ronald Shelton, MD
Manhattan Dermatologist

General anesthesia help to avoid using so much lidocaine

Yes it does. There are measurements concerning the loading doses of lido. to be used and time frame in amounts vs time of duration. Hope that helps Dr. B

Darryl J. Blinski, MD
Miami Plastic Surgeon

Lidocaine with lipo under a general

If a general anesthetic is done when a patient is having liposuction then lidocaine is not needed . Depending on what type of general is used lidocaine may help the anesthetic by not requiring as deep an anesthetic. These things can and should be worked out between the surgeon and anesthesiologist prior to surgery. The dose of lidocaine can be substantially reduced if the procedure is done under a general.

Walter D. Gracia, MD
Arlington Plastic Surgeon

General Anesthesia and Lidocaine

Yes, if you have general anesthesia, the total amount of lidocaine can be limited since you will not feel the surgery. If you are having awake liposuction, then a larger amount of lidocaine is required per area to make sure that you do not feel the procedure. Because of this, fewer areas can be treated with awake liposuction than with traditional liposuction under general anesthesia. Good luck.

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Liposuction under general anesthesia

By using a physician anesthesiologist and general anesthesia, the surgeon can limit the total amount of lidocaine added to the tumescent fluid and mimimize the risk of lidocaine toxicity.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Risks of liposuction

There are two categories of risks in liposuction that you are referring to. One is that related to anesthesia, especially lidocaine toxicity. This is a real concern that is related to the amount of liposuction, both volume and surface area, and the type of supplemental anesthesia. While the lidocaine dose can be monitored and controlled, some surgeons do not even use the lidocaine, but use the injection fluid to deliver epinephrine to reduce bleeding rather than pain control. Certainly the... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Lidocaine use in Liposuction

There are many ways to provide anesthesia for liposuction. If the surgeon you select is experienced, you should be able to have whatever you desire treated no matter what kind of anesthesia you select. With tumescent anesthesia, this requires carefully calculation of the dose of Lidocaine used and dividing it between the areas liposuctioned. There is, however, a difference between what amount of Lidocaine different people consider safe. For many years, 35 mgm/kg body weight has been the... more