Dr. Jeffrey Klein presents an instructional video for the use of tumescent lidocaine anesthesia for optimal MiraDry results.
This instructional video features the benefits of tumescent lidocaine anesthesia or tla when performed on an actual patient having the miradry procedure i am a little bit nervous i’m concerned about the downtime the pain i’m a little bit of a procedure wimp probably like many people and so i’m excited and apprehensive today about trying the miradry procedure we
Now introduce to you dr. jeffrey kline the inventor of tumescent lidocaine anesthesia hello i’m dr. jeffrey kline inventor of tumescent lidocaine anesthesia this instructional video presents the use of tumescent lidocaine anesthesia for optimal new dry results the engineers who designed the miradry device were not familiar with the superior safety and clinical
Advantages of tumescent lidocaine anesthesia compared to out of the bottle 1% lidocaine with epinephrine i often refer to tumescent lidocaine anesthesia as tla tla consists of approximately a tenfold dilution of 1% lidocaine with epinephrine in a bag of normal saline commercial lidocaine with epinephrine is an acidic solution in order to prolong the shelf life of
The epinephrine and to increase the solubility of lidocaine however for tumescent lidocaine anesthesia we raise the ph of the solution with 3 mil equivalents of sodium bicarbonate we have a ph of 7.4 epinephrine has a half-life of about 4 weeks thus the neutral ph epinephrine loses its ability to provide vasoconstriction within a few weeks temesta the lidocaine
Anesthesia is accomplished using a cline pump and tumescent infiltration tubing the personalities you can’t be delivered with a handheld syringe and a needle however the infiltration using a peristaltic pump is much more efficient and more comfortable for the patient the use of 1% lidocaine with epinephrine can be both uncomfortable and perhaps a bit unsafe when the
Maximum dosage is used the maximum volume of 1% lidocaine with epinephrine out of a commercial bottle is approximately 50 milliliters or about 25 milliliters for each egg zillah at this dosage patients frequently experience tachycardia and tremors this limited volume of commercial 1% lidocaine with epinephrine limits the effectiveness of the local anesthesia around
The periphery of the axilla with a commercial solution of lidocaine with epinephrine the local anesthesia around the periphery of the axilla is suboptimal and patients may experience some discomfort when this portion of the exile is treated with miradry this limited volume of local anesthesia limits the area that can be treated with miradry as well as limiting the
Intensity of the miradry power output thus this limits the efficacy of the miradry treatment tla for miradry typically requires 283 milliliters of solution this consists of a 250 bag of normal saline together with 30 milliliters of 1% lidocaine and epinephrine plus 3 milliliters of 8.4% sodium bicarbonate every bag of tla solution must have a safety label stating
Subcutaneous tumescent lidocaine not for id this is to prevent the inadvertent iv delivery a large volume of anesthesia containing lidocaine and this little tab is to remind the person that is not for iv a separate bag of tl a solution must be prepared for each patient and a new tumescent infiltration tubing must be used for each patient as well the supplies
Required for tla include a sterile procedure tray 2 5 milliliters syringes – 30 gauge 1/2 inch needles 1 spinal needle either 25 gauge or 20 gauge sterile gauze 4 by 4 pads chlorhexidine gluconate scrub and sterile saline rinse also required is hk – medicine in filtration tubing for the use with the hk klein peristaltic pump and a stainless steel hex connector
For filling syringes and securing the tubing to the tray the sequential steps for – mesta infiltration for miradry include first the commission washing hands than putting on safety goggles facemask flying gloves and an apron next both exilic are anesthetized with pla first one exile is anesthetized apply chlorhexidine gluconate scrub and then rinse with sterile
Saline apply appropriately-sized miradry template both by cc syringes with commencin solution then attached a 30 gauge needle inject 45 intradermal one milliliter bloods of tumescent solution using a 30 gauge needle the spinal needle will be inserted through the blood into the subcutaneous tissue attach the spinal needle to the hk tumescent infiltration tubing
The commission’s non-dominant hand gently grasps and slightly elevates the axillary skin the dominant hand holds the spinal needle the needle is inserted through the blood and then advanced within the superficial subcutaneous tissue using a gentle in and out motion in a fanning pattern in order to avoid inadvertently inserting a spinal needle too deeply the tip
Of the spinal needle should always be maintained between the fingers and thumb of the non-dominant hand as it grasps the axillary skin about 100 to 120 milliliters of tla solution is infiltrated into each exilic notice the blanching of the skin following adequate tumescent infiltration if there is an area that is not completely branched this might indicate an area
Of inadequate local anesthesia by the time the second exile has been too messed the first side will be optimally anesthetized and ready for miradry treatment when the miradry treatment is combined with tumescent lidocaine anesthesia patients experience minor discomfort and in most cases can return to work or normal activities later that day i don’t know what i
Was so worried about the numbing process had very little discomfort and the procedure itself was painless now we can go back to work wearing my beautiful bright colors and not have perspiration stains i’m so glad i had this done and now i can go back to the office for more information on the miradry system and training please contact miradry directly for academic
Information please go online to tumescent org or to purchase the hk surgical tubing and the klein infiltration pump go to hk surgical comm
Transcribed from video
Tumescent Lidocaine Anesthesia for MiraDry Procedure By HK Surgical