A COMPARATIVE STUDY BETWEEN TRUE TUMESCENT LOCAL ANESTHESIA TECHNIQUE AND OTHER CONVENTIONAL ANESTHETIC REGIMENS IN LIPOSUCTION

Abstract

Tumescent anesthesia describes the practice of injecting a dilute solution of LA combined with epinephrine and sodium bicarbonate into subcutaneous tissue until it becomes firm and tense. The primary benefits behind this technique is to avoid the supposed risks of general anesthesia, decrease blood loss in surgeries and provide postoperative anesthesia up to 18 hours. The underlying principle of tumescent anesthesia is that contrary to conventional thinking, larger doses of lidocaine, even up to 35-55 mg/kg body weight can be administered safely. Tumescent anesthesia has enormous potential for the future and while it is a safe practice, one needs to be acutely aware of the patient factors which are likely to correlate with increased perioperative risks. These factors include BMI, ASA classification and coexisting hepatic or renal insufficiency, as well as the presence of inhibitors or substrates for the P450 hepatic microsomal system. Tumescent liposuction refers to the refinement of the traditional liposuction procedure. This technique involves subcutaneous infiltration of high volumes of crystalloid fluids containing low concentrations of lidocaine and epinephrine followed by suction-assisted aspiration of fat. The term tumescent liposuction specifically excludes the use of any additional anesthesia medications at dosages that have a significant risk for impairing the protective airway reflexes or for suppressing the respiratory drive. It is a method for performing liposuction surgery with the patient under local anesthesia.