Buffered lidocaine expiration dating validating web pages
In this book the word is a quantity of a medicine given at one time and measured in milligrams (mg).
Before discussing the formulation of tumescent solutions for local anesthesia, the following concepts and warnings must be emphasized to minimize the risks of lidocaine toxicity.
Patients taking pseudoephedrine for nasal decongestion or “health food” supplements that contain ephedrine-like chemicals are predisposed to epinephrine-associated tachycardia.
Also, the patient may have an undiagnosed primary cardiac arrhythmia (dysrhythmia), an occult cardiac valvular disease with intermittent tachycardia, or a subclinical metabolic disorder (e.g., hyperthyroidism, carcinoid, pheochromocytoma).
In some patients, especially older persons, it is wise initially to limit the amount of liposuction to relatively small volumes.
Once the first procedure has been completed without evidence of tachycardia, tremor, or an anxiety reaction, the surgeon can proceed 1 or 2 months later with a standard dose of epinephrine for tumescent anesthesia.
Anesthesiologists must be familiar with the pharmacology and pathophysiology of tumescent liposuction to be in compliance with American Society of Anesthesiologists (ASA) standards.
It is specifically intended for the surgeon who wants to check the completeness of the anesthesia just before beginning liposuction.Safe doses of tumescent (very dilute) lidocaine and epinephrine are not the same for “out-of-the-bottle” commercial (considerably more concentrated) lidocaine.Whereas the safe maximum dosage of tumescent lidocaine (with epinephrine) at concentrations of 0.05% to 0.15% is 45 to 50 mg/kg, the traditional dosage limitation for commercial lidocaine (with epinephrine) at concentrations of 0.5%, 1%, or 2% remains valid at 7 mg/kg.No standard, official, or rigidly prescribed formulation exists for tumescent anesthetic solutions.Concentrations of the lidocaine and epinephrine should depend on the areas treated and the clinical situation.
The routine use of clonidine (0.1 mg) given preoperatively to patients without bradycardia or hypotension has greatly reduced the incidence of intraoperative and postoperative tachycardia with tumescent local anesthesia. The physician can vary the concentration of epinephrine depending on the particular area that is being targeted for tumescent liposuction.