Blood Work and EKG for Smart Lipo?

I am a 44-year-old woman who is having Smart Lipo in Feb 2010. My doctor wants me to do blood work (which I understand) and an EKG. Why would he request this second test? I am healthy, but do have reactions to anesthesia (I have had Smart Lipo with level 1 sedation and was nauseated afterward, but he said he can counteract that with medicine before the surgery. I am concerned about the EKG. Thanks.

Doctor Answers 5

EKG and lab workup prior to anesthesia

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Guidelines vary by state, instittuion and practitioner. Traditionally many years ago nearly everyone over 30 had to get an EKG prior to general anesthesia. Now that has generally been limited to anyone with a history of cardiac disease or age over 50. Perhaps there was somethng in your medical history that concerned the practitioner or required by the anestesiologist.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Preop EKG

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 If you were over 60, an EKG would be required for anesthesia in my facility.  Otherwise, if you are younger and healthy with no cardiac symptoms, there would not usually be a need for an EKG.  On the other hand, it is a harmless and easy test so if your doctor wants it, why not do it? 

Pre-tests before Smart Lipo

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The question leaves out some very important information. Specifically what type of anesthesia? Local only, local with oral sedation, local with IV sedation (deep), light general (face mask or LMA) with local, or deep general with local are the choices. In the State of Florida, the Board of Medicine's office surgery guidelines for IV or any types of general anesthesia requires blood and urine pre testing + EKG (if any medical issues) over the age of 40 years. If less than age 40 than it depends on the types of anesthesia if blood and urine pre testing is needed.

It sounds like you are having extensive smart lipo so that is why your doctor is requiring these pre tests. Also, it is for your safety.

3 months ago in Ft. Lauderdale there was a liposuction death in a 30-ish mother of three from over dosing on lidocaine. This was at a Med spa without a crash cart, oxygen, IV solutions, etc. just a thoughtless doctor who overdosed a healthy patient on lidocaine. PLEASE be careful out there.

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Preoperative work up

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For healthy patients over 40, I usualy have patients get basic lab work and a medical clearance from their doctor. Every doctor is different, I would not be too concerned about the EKG.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Ask questions when uncertain

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If your doctor has recommended the blood tests and the EKG you should ask him why, if it is routine, or did he/she pick up something in your history they were concerned about, etc. Also, ask what he use to counteract the nausea. I do SmartLipo under local anesthesia with oral sedation and rarely have a problem with nausea, but have medications that help with it that can be used prior to the procedure. You should always ask questions to your physician whenever something is recommended and you don't understand why. How your physician answers may give you insight as to how he will treat you - that is, if he has enough time to address your concerns and to set you at ease or is he anxious to get on to the next patient.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.