Efficacy of tumescent local anesthesia with variable lidocaine concentration in 3430 consecutive cases of liposuction

Abstract

Background: Lidocaine toxicity is a potential complication related to using tumescent local anesthesia (TLA) as the exclusive form of pain management in surgical procedures.

Objective: We sought to determine the minimum concentration of lidocaine in the tumescent solution required to provide adequate anesthesia in patients undergoing liposuction using TLA exclusively.

Methods: Liposuction using TLA exclusively was performed in 3430 procedures by the same surgeon. The initial concentration of 1000 mg/L lidocaine in the tumescent solution was gradually reduced to find the minimum required for adequate anesthesia.

Results: Adequate anesthesia was achieved using a lidocaine concentration of 500 mg/L saline in all areas treated and 400 mg/L saline for most of the areas treated.

Limitations: Data are based on the specific TLA technique used by the same surgeon. Lidocaine serum levels were not analyzed.

Conclusion: For patients undergoing liposuction using TLA exclusively, the concentration of lidocaine in the normal saline solution required for adequate anesthesia is 400 mg/L for most body areas and 500 mg/L for some sensitive areas.