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Anesthesiology
Cosmetic Surgery Leaves Thornton Teen Brain Damaged
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<blockquote data-quote="epidural man" data-source="post: 22221843" data-attributes="member: 153158"><p>Why do you all not think this death was LAST? Intercostal are basically giving it IV. </p><p></p><p>Regarding tumulscent lidocaine, </p><p></p><p>I quit working at a plastic surgeons office because of this issue. I just wasn’t comfortable with the levels. </p><p></p><p>I don’t care what Derm literature says because in the end, the FDA says - you better not use </p><p>More than 7mg/kg. I feel like that is pretty clear by a powerful regulating body. </p><p></p><p>One of my wonderful mentors, Red Howard, had this to say to me some years ago on the subject. </p><p></p><p>“ Despite all the published self-serving "safety studies" now in the dermatologic literature, I remain unpersuaded that patient safety is the underlying motive behind the increasing popularity of using mega-dose lidocaine in liposuction. This situation seems all too similar to the recent attempts by gastroenterologists when they ask that we allow nurses without adequate training in anesthesia to push propofol during colonoscopies. And when a "dermatologic surgeon" asks me to provide MAC while he administers tumescent local, I get a sense, albeit a bit different, akin to being asked to provide anesthesia for chiropractic manipulation -- it is something that has probably been done profitably thousands of times, but doing so just seems contrary to the high expectation I have of the anesthesiologist as the physician who protects the patient from those rare demons of injury that still lurk in the surgical theater. The simplistic horrors of pre-anesthetic surgery have been banished for over 150 years, so the the sophisticated anesthesiologist worth his seasoned salt now confronts rarer, subtler dangers as surgeons today push the few limits we have empirically, even if unscientifically, set for ourselves. “</p></blockquote><p></p>
[QUOTE="epidural man, post: 22221843, member: 153158"] Why do you all not think this death was LAST? Intercostal are basically giving it IV. Regarding tumulscent lidocaine, I quit working at a plastic surgeons office because of this issue. I just wasn’t comfortable with the levels. I don’t care what Derm literature says because in the end, the FDA says - you better not use More than 7mg/kg. I feel like that is pretty clear by a powerful regulating body. One of my wonderful mentors, Red Howard, had this to say to me some years ago on the subject. “ Despite all the published self-serving "safety studies" now in the dermatologic literature, I remain unpersuaded that patient safety is the underlying motive behind the increasing popularity of using mega-dose lidocaine in liposuction. This situation seems all too similar to the recent attempts by gastroenterologists when they ask that we allow nurses without adequate training in anesthesia to push propofol during colonoscopies. And when a "dermatologic surgeon" asks me to provide MAC while he administers tumescent local, I get a sense, albeit a bit different, akin to being asked to provide anesthesia for chiropractic manipulation -- it is something that has probably been done profitably thousands of times, but doing so just seems contrary to the high expectation I have of the anesthesiologist as the physician who protects the patient from those rare demons of injury that still lurk in the surgical theater. The simplistic horrors of pre-anesthetic surgery have been banished for over 150 years, so the the sophisticated anesthesiologist worth his seasoned salt now confronts rarer, subtler dangers as surgeons today push the few limits we have empirically, even if unscientifically, set for ourselves. “ [/QUOTE]
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