Tumescent Technique for Vein Stripping

Updated March 19, 2013
Author: VerLee

Description: Vein Stripping for Paul Bloch involves infiltration of these solutions


Introduction

Paul Bloch uses a Lidocaine/Epinephrine/Saline mixture as part of his technique to strip varicosities in the lower extremities.


Background

This technique is documented in several surgical journals:


The Solutions

Depending on the volume Bloch thinks is necessary, there are two different solutions he has asked to be mixed up:

Tumescence Solution A:
1000 cc NS
40 cc 2% Lidocaine (800 mg)
2 cc 1:1000 Epinephrine (2000 mcg)
Total Volume: 1042 cc

xylocaine concentration = 0.77mg/cc
epi concentration= 1.9 mcg/cc

Tumescence Solution B:

3000 CC NS
150 cc 1% Lidocaine (1500 mg)
6cc 1:1000 Epinephrine (6000 mcg)
Total Volume : 3156 cc

xylocaine concentration = 0.48mg/cc
epi concentration= 1.9 mcg/cc


Caveats

If infused completely, that's a lot of lidocaine, over the Systemic Toxicity level by most measures