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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, also known as lignocaine and sold under the brand name Xylocaine among others, is a local anesthetic of the amino amide type. [10] It is also used to treat ventricular tachycardia and ventricular fibrillation .
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]
Iontocaine, consisting of lidocaine and epinephrine Septocaine (trade name Septodont), a combination of articaine and epinephrine One combination product of this type is used topically for surface anaesthesia, TAC (5–12% tetracaine , 1 / 2000 (0.05%, 500 ppm , 1 ⁄ 2 per mille) adrenaline, 4 or 10% cocaine).
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]
Occasionally a 'pop' is felt as the needle tip passes through the muscle cone delineating the retrobulbar space. Following a negative aspiration for blood, 2–4 mLs of local anesthetic solution is injected and the needle is withdrawn. 2% Lidocaine (Xylocaine) and 0.5% to 0.75% bupivicaine (Marcaine) are two commonly used agents. Epinephrine ...