this is a two-part question for anyone to answer, as i am unable to get a definitive answer.

1st case (question) involves bladder hydrodistention on 71 kg female - surgeon injects somewhere upwards of 80 ml 1% lido/0.25% bupiv/HCO3 mix into bladder at end of procedure. i've never seen this before, so i inquired about toxicity. she said she hasn't heard of this technique causing issues, but could not give me any concrete literature/support. one case report i read was on a 2.5 yr old that developed toxicity symptoms after only 10 ml injection into bladder for spasms. i get the low absorption rate via infiltration into fat tissue, but just curious if anyone else would have a concern here.

2nd case (question) involves orbit exenteration on 48 kg female - surgeon injects 10 ml of 2% lido plain into and around eye, and said that they will need quite a bit more. i told them that they were just about near toxic dose, and that if they wanted to stretch the volume, consider using 4 ml of 1% instead of 2 ml of 2% lido. i haven't been able to find absorption rate in such a vascular place, so i ask again... any concerns here?