New England electrologists offering local anaesthetic shots

suggestions located near Boston especially appreciated.

thanks much.

</font><blockquote><font size=“1” face=“Verdana, Helvetica, sans-serif”>quote:</font><hr /><font size=“2” face=“Verdana, Helvetica, sans-serif”>Originally posted by Tryste:
suggestions located near Boston especially appreciated.

thanks much.</font><hr /></blockquote><font size=“2” face=“Verdana, Helvetica, sans-serif”>Good luck finding them.

Why not just do the anesthetic shots yourself?

Are you nuts? Take it from a medical professional - injecting local anesthesia is not a do-it-yourself project. It’s not the same as giving yourself an allergy or insulin shot. Unless you’ve had specific training in this area and know exactly what you’re doing, leave this to a trained medical professional. In virtually every state, I would think injection of local anesthetics would be restricted by law to physician, nurses, and PA’s. The medications are certainly not available without a prescription.

Fine, but I was just asking the question.

Perhaps you could help enlighten people about the dangers. After all, there are web pages out there with discussions on them of self administered anesthetics. Doubtless the intelligent readers of this forum will ask the questions, and it would be most helpful if you could distill it.

[ January 08, 2004, 09:01 AM: Message edited by: DIY’er ]

Link to the page shown below - it has an excellent section on the risks of DIY injection of local anesthesia.

The primary risks have to do with local anesthetic toxicity, which can cause seizures and death. There are similar risks with topically applied anesthetics, but because they are usually absorbed slowly, the risk of toxicity is much lower.

http://www.hairfacts.com/tips/pain/painrisks.html

Hm. With all due respect to Andrea – and it’s quite a bit of respect – I wouldn’t exactly characterize “DON’T DO IT” as “excellent”, though as a survey that page is pretty good.

I did a bit of research and have only gotten more curious. I understand the risk of accidentally injecting the lidocaine into a vessel. But I’m puzzled: Sometimes lidocaine is administered intravenously. What’s the difference between that and accidentally injecting it? The maximum dosing for infiltration and intravenous is the same, at least according to Rxlist.

Actually, the medical-professional-administered shots aren’t much safer, if following the shot you leave and go to your electrologist!

It would be worth anyone considering going to an electrologist offering local anesthetic to understand the risk factors for local anesthetic. That is, they should watch the practitioner to make sure they aspirate the injection, and so on.

I also got to thinking about something: Maybe it’s because of electrolysis’s origins as a cosmetic procedure, but how many other painful medical procedures are performed with so little accommodation for pain? It’s almost like the Wild West: Here’s a bullet to bite down on.

I read elsewhere that someone snorted – yes, snorted – 1cc of lidocaine solution. No reports on the strength of solution, but I imagine that it entered the bloodstream pretty fast. Jeez.

[ January 08, 2004, 08:30 AM: Message edited by: DIY’er ]

There are so many variables. Concentration of drug, volume injected, time of injection, where it’s injected, whether or not it contains preservatives that some people are allergic to, etc. Different drugs have different potentials for problems. Lidocaine when used properly and in the right dosage is perfectly safe IV. Bupivacaine injected IV will cause a seizure and potentially cardiac arrest, even in relatively small doses. 1cc of lidocaine snorted? Not a problem if it’s 0.5%. Could be much different if it’s 4%. Could be catastrophic if injected into the carotid artery, which I have seen done by a physician who wasn’t paying attention to what he was doing.

Plastic surgeons performing liposuction use large volumes of tumescent solution containing dilute concentrations of lidocaine. Not usually a problem here either (not usually), yet there are numerous reports of deaths during and following liposuction procedures, many due to local anesthetic toxicity.

How many people are told they are allergic to lidocaine or novocaine (which are truly extremely rare allergies) when what really happened is that their careless dentist injected some local with epinephrine either directly IV or intra-arterially causing severe tachycardias or seizures? They tell the patient they had an “allergic reaction” to the medication to cover their ass, and most patients don’t know any better.

All I’m trying to convey here is that there are significant risks when using injectable local anesthetics, sometimes even in trained hands. I think it’s foolish for anyone to consider doing it themselves.

DIY’er, you might trust yourself to give your an injection. I wouldn’t, though, trust myself to give myself an injection. Aside from the trouble I would have in obtaining the perscription.

Question got me thinking about my own assumptions,though.

It’s a great discussion.

When I first posted, I didn’t know a damn thing about local anesthetics. Now I am going to ask my dentist what kind and what dose of anesthetic I am receiving, and ask whether they aspirate before the injection.

I also would not recommend self injection, or injection followed by solitary periods, such as driving from the injection site to the electrologist.

Tryste, this gives you a lot of good things to think about, and questions to ask should you go in for electrolysis with local anesthetic. If I were you I would try electrolysis with the topicals and pursue local if they were not adequate. Like I said earlier, I can’t imagine any other medical procedure in which so little accommodation is made for pain. An amusing aside: One of the primary applications for topicals is to ease the pain of administering the local!

One guideline I saw frequently repeated: Start low and add additional anesthetic should the pain not be adequately managed. I have only once received that sort of treatment. Also, if you are doing staged treatments, do multiple, smaller injections.

For example, Andrea points out that local anesthetic raises the possibility of overtreatment, because the pain is not there for feedback. Well, the safe way to do it would be to start with a small dose and add to it should the patient complain of pain. Her assumption illustrates the flawed practice of injecting a large quantity to start with and then not bothering with it again – such as you’d get if you went to a dentist for a shot and then to your electroligist.

It wouldn’t at all surprise me if the practice was to inject up to 50% of the safe toxic threshold, and then leave it at that.

[ January 08, 2004, 08:54 AM: Message edited by: DIY’er ]

JWK, do you by any chance have links to information about the incidence of toxicity as a result of accidental intravascular injection? I’m still puzzled as to why it would be toxic that way and not intravenously. Is it the rapidity with which it reaches the heart? Are there specifications for how slowly the IV administers? Or perhaps because the surgeon then has to repeat the dosage for the local?

Thanks for your inputs, by the way.