Expert: Ronald Levy, M.D. - 6/16/2008

Question
QUESTION: Mr. Levy I am very concern about the following and need your expert advice.
Every time I am injected with lidocaine my blood pressure drop to the point I faint.
2 year ago I had a left elbow surgery and my surgeon told me I had my Anesthesiologist worry.
1 year ago I had lesion removed from my left ear and my surgeon told me I had him worry because my vitals were very low. They had to call in an MD."This one was with local anesthesia".

This week I went for a Thyroid biopsies and it was cancelled because I had blood pressure 80/50 this was also local anesthesia .  My regular blood pressure is 118/70
I have a good healthy diet, weight 200lb  6ft 1 inch,  no known medical problem, not alcohol, not drug.  I forgot when I visit the dentist the same thing happen.

 
I thank you for your time and expertise in advance

M


ANSWER: It sounds strange and I can't say for sure what is causing it. You say it might be lidocaine but there are other local anesthetics they could try (or maybe did try). It doesn't sound like an allergy but there is definitely something going on and it should be evaluated. Beyond that, without examining you or your medical record, I couldn't give you more specific comments.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Thank you for your prompt reply.
How should I go about having this situation evaluated? I was told that lidacaine was going to be used and asked if i was allergic to it.  I always answer no.

Answer
I wouldn't necessarily answer no. I would tell them that, while you don't think you are allergic to Lidocaine, you have had this strange reaction. There are other local anesthetics they can use (different class) if they are concerned. As for testing, an Allergist can do the testing for you.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston