Local anesthesia for Lipo/smart?

Question

I was reading when under going a local anesthesia procedure for lipo that there is a general risk from lidocaine toxicity for up to 12-16 hours post op? If this is true then why is this procedure done on out patient protocol ? Or is the chances of this complication very low ?

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, lidocaine peaks at 12 hours after surgery. Most patients can tolerate safely 35 mg per kg of their weight. If they are on lipitor or anti-depressants the dose should be lowered and probably the patient should be switched to general anesthesia so the dose of lidocaine can be minimized. I have written the safety guidelines for the American Society of Plastic Surgery on this topic and spend a significant time educating doctors on the risks. Awake liposuction with tumescent or high dose lidocaine can be safe but MUST be done only by an expert and there should be at least 2 nurses (registered nurses) present

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Lidocaine toxicity is what happens when you get overdosed with lidocaine. If it's properly dosed, the risk of toxicity is rare. That's why you don't need to stay in the hospital for 12 hours afterwards or have it done at a hospital at all. The blood level of lidocaine tops out at 6-12 hours after it's given, but it doesn't reach toxic levels unless too much was given to begin with. Be aware that lidocaine is also commonly used when the procedure is done under general. Of course, if your doc doesn't know how to properly dose lidocaine there will be trouble. Regardless of the rarity of toxicity, you need a responsible adult by your side overnight afterwards as a precaution.

Navin S. Arora, DO, FAAD · Answer

TimeForAnUpgrade- I believe you are referring to tumescent anesthesia, which is utilized for different types of liposuction- laser, suction, radiofrequency. A benefit of tumescent anesthesia is that general anesthesia is not needed. There are always risks involved with any procedure, however the risk of lido toxicity is extremely low when the proper dosing formula and protocols are implemented.

Local anesthesia for Lipo/smart?

Answers (3)

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