TUMESCENT TECHNIQUE FOR LOCAL-ANESTHESIA IMPROVES SAFETY IN LARGE-VOLUME LIPOSUCTION

The tumescent technique for local anesthesia improves the safety of la rge-volume liposuction (greater-than-or-equal-to 1500 ml of fat) by vi rtually eliminating surgical blood loss and by completely eliminating the risks of general anesthesia. Results of two prospective studies of large-volume liposuction using the tumescent technique are reported. In 112 patients, the mean lidocaine dosage was 33.3 mg/kg, the mean vo lume of aspirated material was 2657 ml, and the mean volume of suprana tant fat was 1945 ml. The mean volume of whole blood aspirated by lipo suction was 18.5 ml. For each 1000 ml of fat removed, 9.7 ml of whole blood was suctioned. In 31 large-volume liposuction patients treated i n 1991, the mean difference between preoperative and 1-week postoperat ive hematocrits was -1.9 percent. The last 87 patients received no par enteral sedation. In a second study, a 75-kg woman received 35 mg/kg o f lidocaine on two separate occasions, first without liposuction and 2 5 days later with liposuction; peak plasma lidocaine concentrations oc curred at 14 and 11 hours after beginning the infiltration and were 2. 37 and 1.86 mug/ml, respectively.