Abstract
Summary: Understanding the clinically important pharmacokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body) of medications used in surgery will help surgeons use them more safely and effectively. The goal of this article is to provide an overview of these considerations for the 2 medications used in wide-awake local anesthesia with no tourniquet upper extremity surgery (ie, lidocaine and epinephrine) to establish a better understanding of lidocaine and epinephrine in tumescent local anesthesia, as well as adverse reactions and how to manage them.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 391e-402e |
| Journal | Plastic and reconstructive surgery |
| Volume | 154 |
| Issue number | 2 |
| DOIs | |
| State | Published - Aug 1 2024 |
Funding
Lidocaine very rarely causes methemoglobinemia; there are no cases reported with WALANT. The largest series of cases of this local anesthetic\u2013induced problem had lidocaine as the cause in only 12 out of 242 cases, with benzocaine and prilocaine being the common culprits. When this happens, patients can become cyanotic and have chocolate-colored blood. This problem responds well to systemic support and supplementary oxygen, sometimes augmented by IV methylene blue injection (1 to 2 mg/kg IV administered over 5 minutes repeated every 60 minutes as required up to a total dose of 7 mg/kg).
ASJC Scopus subject areas
- Surgery