One person is diagnosed with a blood clot every minute. One person dies from a blood clot every six minutes. Visit clotconnect.org to read more.
GENUINE LIDOCAINE ALLERGY
Last Updated: 1/11/2011October 28, 2010 Dr. Ravi responds to Dr. Edmondson & Dr. Bush
I recently have encountered a patient with proven allergy to the xylocain preservative. Since then we have found a manufacturer who makes 2% xylocaine with epi. I am planning to use half the volume. We have done many with lidocaine allergy with ice cold ringer's or saline with no adverse effect. Can't do microphlebectomy.
October 28, 2010 Dr. Bush responds to Dr. Edmondson
Interesting problem although rare.
Dr. Mauriello has discussed this topic many times at the International Venous Congress (IVC) in Miami. There is no cross reactivity among the lidocaine drugs. Hence, you should be able to use one of the other drugs such as marcaine or carbacaine without danger of allergic reaction. You might want to do a small test dose before just to make sure.
You need to use only small amounts of lidocaine drugs in the tumescent solutions. As an alternative, try cold ringers lactate without the lidocaine drug addition. This provides good protection from any heat damage outside the vein and may be enough for analgesia alone.
I don’t blame you for doing this patient in the hospital with some mild sedation especially if you decide to go with the addition of marcaine etc..
I see no need for the use of general anesthesia.
You might want to contact Dr. Mauriello or Dr. Ravi who have used cold ringers lactate for the tumescent solution.
Please let us know on the blog what you end up using. I know from using cutaneous lasers that total anesthesia can be achieved by injecting sub-dermal saline at room temperature.
Ron
John Mauriello M.D. F.A.C.Ph
Dr. Mauriello has been practicing Phlebology for more then 20 years. Vein Magazine, had acknowledged him as one of the 25 most influential venous professionals in the world. A colleague had this to say: "John Mauriello is a Master; I consider him to be one of the pioneers in modern Phlebology. He cares about the profession and is dedicated and committed to its advancement." More anout Dr. Mauriello
Save the Date for IVC 2011!
Plan to do 2nd leg in hospital rather than clinic.
Do we use gen anesthesia and saline tumescent or premedicate with steroids and use another local such as carbacaine or procaine?
We welcome your reviews, thoughts and opinions - send us a message!
* We will post your name, clinic, & link if you wish after each of your responses. You can also remain anonymous if you desire. All posts are reviewed for content and professionalism before posting.Thank you for your understanding, and thank you for your contribution!