Is it dangerous to mix Lidocaine and Metoprolol?

Question

I had a full tummy tuck and lipo in April 2010 and I have some areas on my hips that are kind of lumpy looking so my PS offered to do in-office lipo on those areas using lidocaine. I am on metoprolol (25 mg daily). Is this dangerous to mix the two in an office setting? I have had 2 c-sections but obviously they were in a hospital and my BP was monitored closely. Thanks!

Hayley Brown, MD, FACS · Answer

I feel it is best to do surgery in a fully accredited surgical facility, especially if you have concerns. You may have to pay a little extra for it, but it is money well-spent. Extremely minor touch ups may be safely performed in an office setting, and on your typical medication. I would voice your concerns with your physician, and I am sure they will consider your safety as the first priority.

Ron Shelton, MD · Answer

It may not be the Lidocaine that is the concern, but the epinephrine that is mixed with the lidocaine. If your blood pressure is not always under good control with your medication, then the epinephrine might increase the blood pressure and heart rate. Your internist should provide medical clearance to your surgeon prior to undergoing the liposuction. The epinephrine should not be removed from the local anesthetic as it provides for less bleeding and, very importantly, provides for the safety by slow absorption of the anesthetic, and a longer duration of effectiveness. Without the epinephrine, too much local could be absorbed too quickly creating dangerous toxi levels of lidocaine in the blood.

David Shafer, MD, FACS · Answer

Just like any other procedure, you would need to have medical clearance before this procedure. Assuming that nothing changed between your original operation and now, you will likely be okay. However, this is really a question for your doctors who know you best. Good luck.

Peter E. Johnson, MD · Answer

Metoprolol is a common type of medication to control high blood pressure and is encountered often in cosmetic surgery. Lidocaine is safe to combine with your medication with one caution. Anyone with a stable medical condition should have a medical clearance by their personal physician before surgery to make sure the medications they take are optimal, and the surgery plan is appropriate and compatible from the standpoint of safety. You should be cleared for your liposuction.
	Best of luck,
	peterejohnsonmd

Tracy Pfeifer, MD · Answer

Hi Sueinge,

	Your doctor who knows you would have to answer this question. Why are you on the metoprolol?  There are some medical conditions for which outpatient surgery is contraindicated.  Check with your medical doctor to make sure you are "cleared" to have outpatient surgery with lidocaine.  Hope this helps.

	Tracy M. Pfeifer, MD, MS

Is it dangerous to mix Lidocaine and Metoprolol?

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