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The most common combination of agents used in tumescent anesthesia is lidocaine (0.05-0.10%) and epinephrine (1 ppm). [3] [4] [5] For lidocaine, total doses of 35 mg/kg [6] and 55 mg/kg [7] have been reported as reasonably safe high-end doses, in the context of liposuction.
Lidocaine is an antiarrhythmic medication of the class Ib type. [7] This means it works by blocking sodium channels thus decreasing the rate of contractions of the heart. [10] [7] When injected near nerves, the nerves cannot conduct signals to or from the brain. [8] Lidocaine was discovered in 1946 and went on sale in 1948. [11]
The epinephrine causes vasoconstriction which in turn reduces systemic distribution of the anesthetic as well as prolongs its action in addition to decreasing bleeding at the operating site. Lidocaine 2% with 1:100,000 adrenaline is the local anesthetic of choice in the treatment of pregnant women. [28]
A high dose of local anesthetic, typically lidocaine or prilocaine without adrenaline, [6] is slowly injected as distally as possible into the exsanguinated limb. The veins are filled with the anesthetic, with the anesthetic setting into local tissue after approximately 6–8 minutes, after which the surgery, reduction , or manipulation of the ...
It is used as a eutectic mixture with lidocaine, 50% w/w, as lidocaine/prilocaine. The mixture is an oil with a melting point of 18 °C (64 °F). A 5% emulsion preparation, containing 2.5% each of lidocaine/prilocaine, is marketed by APP Pharmaceuticals under the trade name EMLA (an abbreviation for eutectic mixture of local anesthetics). [3]
Lidocaine, a numbing agent, is another good option, she says, because its direct goal is to help the pain and itchiness. Witch hazel pads also help relieve symptoms.
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