Use Of Lidocaine In Tumescent Liposuction Is Beneficial

In 1987, Dr

In 1987, Dr. Jeffrey Klein invented tumescent liposuction. This technique injects large amounts of diluted lidocaine (a local anesthetic) and epinephrine (a vasoconstrictor) into the targeted fat tissue. The lidocaine numbs the area, preventing pain, and the epinephrine constricts the blood vessels so there it little to no bleeding. Injecting large volumes of this mixture causes the treated area to become swollen and firm, or tumescent, hence the name.

Tumescent liposuction is one of the safest liposuction techniques. Because the anesthetic is diluted and local, no deaths have ever been reported from bad reactions to it. Using general anesthesia or more concentrated anesthetics have caused problems in the past, but the tumescent technique virtually eliminated these risks after the pharmacokinetics of the lidocaine became better understood and this new knowledge was applied.

Pharmacokinetics is the study of the concentration, pathway, and fate of drugs as they travel through the body. The concentration of lidocaine used during liposuction is important to understand, because too much is toxic. So doctors must understand the rates of absorption and elimination of lidocaine and finally determine how many milligrams per kilogram to use. A safe dose is usually about 45 mg/kg for thin patients and 50 mg/kg for average to overweight patients.

Lidocaine can be toxic if its concentration in the blood exceeds 6 mg/liter. It is important to find a surgeon or anesthesiologist who has had specific training in this procedure so that they do not exceed the safe amount of the anesthetic. The only liposuction-related deaths on record occurred because of an excess of anesthetic. However, the process of tumescent liposuction is very safe because its diluted lidocaine has an exceptionally slow rate of absorption, so it is difficult to suffer and overdose.

Before undergoing the tumescent procedure, patients should tell their doctor about any medications they are on. Some drugs, such as anti-depressants, the antibiotic erythromycin, and antifungal drugs, can impair the enzyme in the liver that metabolizes lidocaine, affecting its absorption and elimination. Any drug that may have this effect should be discontinued at least 10 days before surgery, or in some cases the surgeon may be able to use a lower dose of lidocaine.

Because lidocaine is a local anesthetic, it does not put people to sleep and has less effect on the body as a whole. This greatly reduces the risks that are ever present with general anesthetics. It works by quickly blocking small nerves, which send pain and temperature signals to the brain, so during the surgery the patient will have no pain. However, the injection of the lidocaine may sting a little because of the acidic solution it contains, but this can be relieved somewhat by the addition of sodium bicarbonate into the solution.

Tumescent liposuction is probably the most safe of all liposuction techniques. However, people considering it should still educate themselves about the risks of any cosmetic procedure and find a certified, experienced surgeon. Any surgery can end badly when not performed properly by the proper person. Also, liposuction of any kind should not be used excessively. If multiple areas need treated, individual appointments should be made weeks apart from each other.

by: Christian Heftel

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