Intraoperative Use of Bupivacaine for Tumescent Liposuction: The Robert Wood Johnson Experience

Failey, Colin; Vemula, Rahul; Borah, Gregory; Hsia, Henry C.

doi:10.1097/prs.0b013e3181b455d0

Cited by 16 publications

(3 citation statements)

References 22 publications

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“…Importantly, the concentrations of the tested LAs in this study were within the clinically relevant range for tumescent anesthesia. 18,19 The anesthetic formulation of tumescent solution according to Jeffrey Klein, which is one of the most widely used formulas, contains 500 to 1000 mg/L lidocaine and translates to 2.133 to 4.266 mM lidocaine. 20,21 For a synopsis of the concentrations of ready-to-use local anesthetics in the clinical setting, see Table 2.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive analysis of local anesthetics affecting adipose stem cells, in vitro

Guillaume

Lippold

Beier

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Adipose stem cells (ASCs) hold a great regenerative capacity because of their differentiation capability and their secretory activity. Thus, ASC survival is of great significance during perioperative harvesting. Various local anesthetics are commonly applied during fat grafting procedures. These substances are known to impair cellular viability, which would affect graft survival and final outcomes, but the exact extent of their impact on ASC biology is unknown. Methods: The authors analyzed the short- and long-term effects of lidocaine, mepivacaine, ropivacaine, and bupivacaine at increasing concentrations (0.1 to 10 mM) on primary human ASC proliferation and metabolic activity. Trilinear differentiation was assessed by oil red O stain (adipogenesis), safranin O (chondrogenesis), and cresolphthalein (osteogenesis) labeling. In supernatants, cytokine [interleukin (IL)-6/IL-8, vascular endothelial growth factor, hepatocyte growth factor] secretion was analyzed by enzyme-linked immunosorbent assay. Results: Bupivacaine at greater than 100 µM demonstrated the strongest anti proliferative effects, whereas lidocaine and ropivacaine did not affect cell numbers. Mepivacaine evoked reciprocal results regarding cell count at greater than 1 mM. Each compound impaired trilinear differentiation. Secretion of hepatocyte growth factor and IL-8 was reduced significantly by local anesthetic exposure; levels were restored after substances were washed out. Conclusions: In vitro data show that lidocaine, mepivacaine, and ropivacaine could be applied at concentrations of 1 to 10 mM without affecting ASC survival. In contrast, bupivacaine at concentrations greater than 100 µM should be administered with great caution. The differentiation of ASCs and the ASC’s secretome might already be decreased by each local anesthetic at 1 mM. Clinical Relevance Statement: The authors’ experimental data can be of great significance to the clinical practice, as local anesthetics are routinely administered during liposuction as a tumescent anesthesia adjunct. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

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Section: Discussionmentioning

confidence: 99%

Comprehensive analysis of local anesthetics affecting adipose stem cells, in vitro

Guillaume

Lippold

Beier

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…For other LAs like ropivacaine, bupivacaine and levo-bupivacaine, and due to their higher relative potency and their potential higher systemic toxicity (Table 1), doses could be 10 fold less compared to lidocaine [59,60]. The use of long-acting LAs as bupivacaine may offer interesting postoperative analgesia [61] but these drugs are poorly referenced in the context of fat grafting, in which appropriate doses and effects are not well known. This is the same lack of knowledge regarding prilocaine, which has also been used for tumescent anesthesia (maximal dose of 15 mg/kg for safe liposuction) [62].…”

Section: Currently Used Las In Afgmentioning

confidence: 99%

Local Anesthetics: Use and Effects in Autologous fat Grafting

AC¹

2013

Surgery

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“…This de la yed deg ra da ti on ac co unts for the long du ra ti on of ac ti on of bu pi vaca i ne, which is 3 to 9 ho urs. 7 …”

mentioning

confidence: 99%

Local Anesthetic Administration Into Uterine Ligaments or Pelvic Cavity to Attenuate Surgical Stress Response During Abdominal Hysterectomy

Kocamanoğlu¹,

Şener²,

Çetinkaya³

et al. 2011

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Sur gi cally in du ced ne u ral ref lex res pon ses and en doc ri ne me ta bo lic ca tabo lic res pon ses sho uld be al le vi a ted by ef fec ti ve pa in-re li e ving tech ni qu es and ne u ral bloc k. The aim of this study was to com pa re the ef fects of two dif fe rent lo cal anest he si a tech ni qu es on the stress res pon se du ring ab do mi nal hyste rec tomy. M Ma at te er ri ia al l a an nd d M Me et t h ho od ds s: : In this pros pec ti ve, rando mi zed study, 60 pa ti ents ad mit ted for be nign ute ri ne di se a ses we re di vi ded in to thre e gro ups; ge ne ral anest he si a alo ne (Gro up CO-gro up con trol); ge ne ral anest he si a plus 3 mL bu pi va ca i ne (0.5%) which was in jec ted in to the ro und and ute ro sac ral li ga ments (Gro up IN-gro up in fil tra ti on) bi la te rally, and ge ne ral anest he si a plus pel vic ca vity ir ri ga ti on with 40 mL bu pi va ca i ne (0.125%) (gro up IR-gro up ir ri ga ti on). The he art ra te, me an ar te ri al pres su re, plas ma glu co se and cor ti sol levels we re re cor ded pe ri o pe ra ti vely. Re co very ti me was recorded and Nu me ri cal Ra ting Sca le for pa in was obtained 15 mi nu tes af ter ex tu ba ti on. R Re e s su ul lt ts s: : He art ra te was the hig hest in Gro up CO com pa red to the ot her gro ups fol lo wing the ute ri ne re mo val and at the pos to pe ra ti ve 15 th mi nu te (P< 0.05). The plas ma cor ti sol le vel was the lo west in Gro up IN fol lo wing the ute ri ne re mo val and the hig hest in Gro up CO at the pos to pe ra ti ve 15th mi nu te (P< 0.05). Va lu es of Nu me ri cal Ra ting Sca le for pa in we re si mi lar among the gro ups (P> 0.05). C Co on nc c l lu u s si i o on ns s: : In ad di ti on to ge ne ral anest he si a, lo cal anest he tic ad mi nis tra ti on in to the ute ri ne li ga ments or the pel vic ca vity may be more ef fec ti ve in at te nu a ting the sur gi cal stress res pon se es pe ci ally in whom this stress res pon se wo uld be de le te ri o us. K Ke ey y W Wo or rd ds s: : Hydro cor ti so ne; blo od glu co se; ro und li ga ment; bu pi va ca i ne Ö ÖZ ZE ET T A Am ma aç ç: : Cer ra hi nin ne den ol du ğu nö ral ref leks tep ki ler ve en dok rin me ta bo lik ka ta bo lik ce vap lar et ki li ağ rı-tek nik le ri ve si nir sel blo kaj ile azal tıl ma lı dır. Bu ça lış ma da ab do mi nal his terek to mi sı ra sın da stres ya nı tı na iki fark lı lo kal anes te zi tek ni ği nin et ki le ri nin kar şı laş tı rıl ma sı amaç lan mış tır. G Ge er re eç ç v ve e Y Yö ön n t te em ml le er r: : Bu pros pek tif, ran do mi ze ça lış ma da, iyi huy lu ute rin has talı ğı ne de niy le baş vu ran 60 has ta üç gru ba ay rıl dı; tek ba şı na ge nel anes te zi gru bu (Grup CO-kontrol grup); ge nel anes te zi ye ek ola rak bi la te ral ro und ve ute ro sak ral li ga ment içi ne 3 ml bu pi va ka in (%0.5) en jek te edi len grup (Grup IN-in fil tras yon gru bu) ve ge nel anes te zi ye ek olarak 40 ml bu pi va ka in (%0.125) ile pel vik ka vi te ir ri gas yon gru bu (gru...

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Intraoperative Use of Bupivacaine for Tumescent Liposuction: The Robert Wood Johnson Experience

Cited by 16 publications

References 22 publications

Comprehensive analysis of local anesthetics affecting adipose stem cells, in vitro

Comprehensive analysis of local anesthetics affecting adipose stem cells, in vitro

Local Anesthetics: Use and Effects in Autologous fat Grafting

Local Anesthetic Administration Into Uterine Ligaments or Pelvic Cavity to Attenuate Surgical Stress Response During Abdominal Hysterectomy

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