Are there risks involved with lidocaine solution being injected into a person and then not removed?

Question

I went to a local doctor to have Smart Lipo on my arms. The doctor stared injecting the solution, and it caused me a lot of pain. I have had liposuction several times, and once with this doctor, and have never had this reaction. Long story short, I had the doctor stop. When I went to see a surgeon about having my arms done under general ( because the first doctor said my arms were probably just very sensitive and that was the problem), he was aghast that the lidocaine was left in my arm.

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

Whomever was aghast was also ignorant of the pharmacodynamics of lidocaine. Lidocaine is fat soluble. That means it attaches to fat cells and nerve sheaths immediately, then gets absorbed slowly by your blood stream where it travels through your liver and eventually gets excreted. The process takes 24 hours from injection to excretion for the small amount of lidocaine that you described. It can't be removed by any mechanical process. Even lipo can't remove more than a small fraction of injected lidocaine. Pain during the injection process is either from injecting under higher than average pressure or from insufficient buffering of the pH of the lidocaine solution.

Gregory Chambon, MD · Answer

The tumescent fluid used to locally numb the area for Smart Lipo is a diluted amount of lidocaine. The amount that can be safely used is calculated by your weight. This amount is safe whether it is aspirated back out or not. It sounds like very little was infused and should not have been an issue as the surgeon was implying. This sounds like a classic case of a doctor putting down a colleague to make himself look smarter. And needlessly stressing you out in the process.

Lawrence Broder, MD (license disciplinary actions) · Answer

The only way to remove the lidocaine in the tumescent anesthesia is to perform the liposuction procedure itself. The vast majority (95%) of the tumescent anesthesia is salt water.  So if liposuction was not performed, your body will absorb the fluid and you will harmlessy urinate it out.

David E. Berman, MD (retired) · Answer

We all use lidocaine with epinephrine and saline to numb up the patient for Smartlipo.some patients are sensitive to the infiltration and all this requires is to inject slower. i personally have most of my patients take both Celebrax and something to relax them by mouth and that makes the numbing part of the procedure, more easily tolerated.We then liposuction out much of the fluid when we take out the fat. however some gets absorbed by the body and that is not harmful at all. The second surgeon did not know what he was talking about. you are still alive and well, so clearly it did not cause you any problems. david berman md

Windell C. Davis-Boutte, MD (license suspended) · Answer

Tumescent liposuction using a dilute form of liposuction is standard practice.  Lidocaine has an acidic pH, so it is usually buffered with sodium bicarbonate before injecting.  Perhaps your surgeon skipped this buffering step, or tried to inject at a high speed causing the skin to extend too quickly.  Nonetheless, lidocaine is readily absorbed by the fat cells, metabolized through the liver and urinated out essentially by the next day with adequate hydration.

Are there risks involved with lidocaine solution being injected into a person and then not removed?

Answers (5)

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