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Tumescent lidocaine

Ashraf Khater, Alaa Mazy, Mona Gad, Ola Taha Abd Eldayem, Mohamed Hegazy
BACKGROUND: Tumescent mastectomy refers to usage of a mixture of lidocaine and epinephrine in a diluting saline solution that makes flaps firm and tense, thus minimizing systemic drugs toxicity and making surgery possible with minimal bleeding. This technique is very useful in elder women and those with American Society of Anesthesiologists; score III and IV. The objective was to establish an alternative safe technique to general anesthesia in some selected mastectomy patients. PATIENTS AND METHODS: Twenty candidate women for total mastectomy and axillary dissection were enrolled and consented to participate...
2017: Breast Cancer: Targets and Therapy
Christopher T Chia, Ryan M Neinstein, Spero J Theodorou
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Review the appropriate indications and techniques for suction-assisted lipectomy body contouring surgery. 2. Accurately calculate the patient limits of lidocaine for safe dosing during the tumescent infiltration phase of liposuction. 3. Determine preoperatively possible "red flags" or symptoms and signs in the patient history and physical examination that may indicate a heightened risk profile for a liposuction procedure...
January 2017: Plastic and Reconstructive Surgery
Joshua J Goldman, Wei Z Wang, Xin-Hua Fang, Shelley J Williams, Richard C Baynosa
BACKGROUND: Our previous study demonstrated that lidocaine has a negative impact on adipose-derived stem cell (ASC) survival. Currently for large-volume liposuction, patients often undergo general anesthesia; therefore, lidocaine subcutaneous anesthesia is nonessential. We hypothesized that removing lidocaine from tumescent might improve stromal vascular fraction (SVF) and ASC survival from the standard tumescent with lidocaine. Ropivacaine is also a commonly used local anesthetic. The effect of ropivacaine on ASC survival was examined...
August 2016: Plastic and Reconstructive Surgery. Global Open
Ilknur Keskin, Mustafa Sutcu, Hilal Eren, Mustafa Keskin
BACKGROUND: Lidocaine and epinephrine could potentially decrease adipocyte viability, but these effects have not been substantiated. The phosphorylation status of perilipin in adipocytes may be predictive of cell viability. Perilipin coats lipid droplets and restricts access of lipases; phospho-perilipin lacks this protective function. OBJECTIVES: The authors investigated the effects of tumescent solution containing lidocaine and epinephrine on the phosphorylation status of perilipin in adipocytes...
February 2017: Aesthetic Surgery Journal
Tom Wallace, Clement Leung, Sandip Nandhra, Nehemiah Samuel, Daniel Carradice, Ian Chetter
OBJECTIVES: To produce a tumescent anaesthesia solution with physiological pH for endovenous thermal ablation and evaluate its influence on peri- and postoperative pain, clinical and quality of life outcomes, and technical success. METHODS: Tumescent anaesthetic solution (0.1% lidocaine with 1:2,000,000 epinephrine) was titrated to physiological pH by buffering with 2 ml incremental aliquots of 8.4% sodium bicarbonate. Patients undergoing great saphenous vein endovenous laser ablation and ambulatory phlebectomy were studied before and after introduction of buffered tumescent anaesthetic...
June 15, 2016: Phlebology
Theddeus O H Prasetyono, Puri A Lestari
BACKGROUND: One-per-mil tumescent solution, which contains 0.2% lidocaine with 1:1,000,000 epinephrine, has been reported to be clinically effective for hand surgery under local anesthesia. However, it was lacking in its basic pharmacokinetics profile in regard to the onset of action (OOA) and duration of action (DOA). METHODS: A randomized, double-blind study was conducted on 12 volunteers who met the inclusion criteria from October to November 2014. All volunteers had their right and left ring finger pulps injected with either one-per-mil solution or 2% lidocaine...
May 2016: Archives of Plastic Surgery
Hiromi Tokumura, Ryohei Nomura, Fumito Saijo, Naoki Matsumura, Akihiro Yasumoto, Mitsuhisa Muto, Yu Katayose, Kennichi Takahashi, Sho Haneda
PURPOSE: Laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) is technically difficult and not infrequently followed by postoperative complications and pain, especially when performed by inexperienced surgeons. To simplify TAPP and reduce postoperative pain, we devised a novel procedure whereby TAPP is carried out after the inguinal preperitoneal infiltration of diluted lidocaine and epinephrine saline solution and carbon dioxide gas (tumescent TAPP). This report introduces the concept of tumescent TAPP and summarizes its operative results...
January 2017: Surgery Today
Arlene J Hudson, David R Whittaker, Dale F Szpisjak, Mark J Lenart, Mercedes M Bailey
OBJECTIVE: Endovenous laser therapy (EVLT) requires tumescent lidocaine anesthesia. Although it is well known that the absorption of local anesthetic varies according to the injection site, little evidence exists establishing the maximum recommended safe dose for extravascular injections such as those used for EVLT. The aim of this study was to evaluate plasma concentration of lidocaine over time after administration of tumescent lidocaine during EVLT procedures in healthy volunteers...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Jeffrey A Klein, Daniel R Jeske
BACKGROUND: Tumescent lidocaine anesthesia consists of subcutaneous injection of relatively large volumes (up to 4 L or more) of dilute lidocaine (≤1 g/L) and epinephrine (≤1 mg/L). Although tumescent lidocaine anesthesia is used for an increasing variety of surgical procedures, the maximum safe dosage is unknown. Our primary aim in this study was to measure serum lidocaine concentrations after subcutaneous administration of tumescent lidocaine with and without liposuction. Our hypotheses were that even with large doses (i...
May 2016: Anesthesia and Analgesia
Henry C Hsia
The use of tumescent solution in liposuction is now considered standard of care; however, much debate still exists regarding its ideal components, especially surrounding the inclusion of local anesthetics. This article reviews the discussion regarding the use of local anesthetics in tumescent liposuction and how it may evolve in the future. The need for local anesthetic additives in tumescent liposuction has been questioned, and the use of longer-acting agents discouraged; however, increasing number of reports in recent years have described the increasingly widespread use of tumescent anesthesia where a wetting solution is infiltrated to achieve anesthesia in an operative field for procedures other than liposuction...
February 2016: Annals of Plastic Surgery
Tokuko Hosoya, Tsuyoshi Nakagawa, Goshi Oda, Hiroyuki Uetake
BACKGROUND: Surgical procedures for breast cancer are usually performed under general anesthesia. However, general anesthesia needs to be avoided in some cases due to patient-related factors such as the presence of comorbid diseases. In these cases, we perform surgery under tumescent local anesthesia(TLA)in our department. SUBJECTS: Seven patients who were diagnosed with breast cancer underwent surgery under TLA instead of general anesthesia due to their comorbidities...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Antonio Rusciani, Giorgio Pietramaggiori, Antonietta Troccola, Stefano Santoprete, Antonio Rotondo, Giuseppe Curinga
BACKGROUND: Tumescent local anesthesia (TLA) technique to obtain regional anesthesia and vasoconstriction of the skin and subcutaneous tissues is routinely adopted for several plastic surgery procedures. Here, we describe the use of TLA in primary subglandular breast augmentation. This series evaluates advantages and disadvantages of TLA in elective augmentation breast surgery as well as patients' response to this procedure. METHODS: Between December 2008 and November 2011, 150 patients underwent bilateral primary subglandular breast augmentation under TLA and conscious sedation in the presence of a board-certified anesthesiologist...
January 2016: Annals of Plastic Surgery
Anne-Claire Girard, Sophie Mirbeau, Lydie Gence, Vincent Hivernaud, Pierre Delarue, Olivier Hulard, Franck Festy, Regis Roche
BACKGROUND: Among the different parameters that influence fat graft survival and lipofilling success, the use of local anesthetic and the way to process the fat before injection have often been pointed out. Likewise, we evaluated different techniques for processing adipose tissue before its injection and analyzed the quality of the grafts. METHODS: Adipose tissue from the same patient was gently harvested from one side of the abdomen after infiltration of a tumescent solution without lidocaine and from the other side of the abdomen using a tumescent solution containing lidocaine 2%...
August 2015: Plastic and Reconstructive Surgery. Global Open
Theddeus O H Prasetyono, Astrid F Koswara
The objective of this report is to present a case of hand burn linear contracture release performed under local anesthesia. It also introduces the one-per-mil tumescent solution consisted of 0.2% lidocaine and 1:1.000.000 epinephrine as a local anesthesia formula, which has the potential of providing adequate anesthesia as well as hemostatic effect during surgery of the hand without tourniquet. The surgery was performed on a 19 year-old male patient with multiple thumb and fingers flexion linear contracture for 105 minutes without any obstacle...
October 2015: Hand Surgery
Jin Hyun Joh, Woo-Shik Kim, In Mok Jung, Ki-Hyuk Park, Taeseung Lee, Jin Mo Kang
UNLABELLED: The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. INDICATION: anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time ≥0.5 seconds and distance from the skin ≥5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2...
December 2014: Vascular Specialist International
Tevfik Gunes, Firat Altin, Baris Kutas, Selim Aydin, Kamuran Erkoc, Bortecin Eygi, Ihsan Alur, Ferit Ozdemir
BACKGROUND: This study aims to investigate the efficacy of lidocaine, prilocaine, and bupivacaine used in tumescent solution during endovenous laser treatment (EVLT) on intraoperative and postoperative pain. METHODS: This prospective randomized study included 90 patients. The patients were divided into 3 groups including 30 patients in each group, according to the content of local anesthetics in tumescent solution. All patients received EVLT treatment with lidocaine in group 1, prilocaine in group 2, and bupivacaine in group 3...
August 2015: Annals of Vascular Surgery
Muhammad Mustehsan Bashir, Rehan Qayyum, Muhammad Hammad Saleem, Kashif Siddique, Farid Ahmad Khan
PURPOSE: To determine the optimal time interval between tumescent local anesthesia infiltration and the start of hand surgery without a tourniquet for improved operative field visibility. METHODS: Patients aged 16 to 60 years who needed contracture release and tendon repair in the hand were enrolled from the outpatient clinic. Patients were randomized to 10-, 15-, or 25-minute intervals between tumescent anesthetic solution infiltration (0.18% lidocaine and 1:221,000 epinephrine) and the start of surgery...
August 2015: Journal of Hand Surgery
Theddeus O H Prasetyono, Debby K A Saputra, Windi Astriana
BACKGROUND: This study aims to explore the effectiveness of one-per-mil tumescent technique in hand surgery, which involves bone and joint. METHODS: This is a case series study on 14 patients with 15 operative fields. One-per-mil solution is formulated by mixing 0.05 mL of 1:1,000 epinephrine and 100 mg lidocaine in 50-mL saline solution. The solution was injected subcutaneously into the operative area until the skin turned pale. The surgery started 7-10 min after the last injection...
March 2015: Hand: Official Journal of the American Association for Hand Surgery
Attila G Krasznai, Tim A Sigterman, Charelle E Willems, Peter Dekkers, Maarten G J Snoeijs, Cees H A Wittens, Cees-Jan Sikkink, Lee H Bouwman
BACKGROUND: Ambulatory Muller phlebectomy for varicose veins can be performed under local anesthesia. However, subcutaneous injection of local tumescent anesthetics may cause discomfort because of acidity of the solution. Addition of sodium bicarbonate lowers the acidity of anesthetic solutions, which might cause less pain. The objective of this study was to study whether alkalinization of the local anesthetic solution with sodium bicarbonate 1.4% decreases perioperative pain during Muller phlebectomies...
April 2015: Annals of Vascular Surgery
Angie M Paik, Lily N Daniali, Edward S Lee, Henry C Hsia
BACKGROUND: Current guidelines favor the use of lidocaine in liposuction wetting solutions. The use of bupivacaine as an alternative remains controversial despite reports of its use with safe and favorable outcomes suggesting faster postoperative recovery time secondary to improved pain control. The goals of this study were to determine the prevalence of bupivacaine use, examine liposuction practices of bupivacaine users, and elucidate opinions regarding bupivacaine use. METHODS: An online survey was distributed to 2500 randomly selected members of the American Society of Plastic Surgeons...
February 2015: Annals of Plastic Surgery
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