Lidocaine-Induced ASC Apoptosis (Tumescent vs. Local Anesthesia)

Abstract

Tumescent anesthesia is the superior method for liposuction with respect to ASC preservation compared to local anesthesia. Lidocaine could cause significant ASC apoptosis.

Tumescent Liposuction without Lidocaine

“…12,13 Because patients often undergo general anesthesia, lidocaine subcutaneous anesthesia seems unnecessary because lidocaine could compromise SVF and ASC survival in the lipoaspirate. 18,26,27 For example, in our previous study, 18 we have reported that lidocaine has significant and a negative impact on ASC survival in the lipoaspirate that is used for fat grafting. Girard et al 26 reported that lidocaine has a negative impact on ASCs even when the ASCs were exposed for only 1 or 2 hours.…”

“…18,22–25 Our prior preliminary data based on 7 subjects indicate that the difference in the response of matched pairs is normally distributed with SD 386.7 and the difference between means is 514.3. If the true difference of ASC number in the mean response of matched pairs is 514.3, we will need to study 6 to 8 pairs of subjects to be able to reject the null hypothesis that this response difference is 0 with probability (power) 0.9 (90%).…”

“…18,22–25 Briefly, 5 mL of lipoaspirate from each liposuction was processed. Lipoaspirate samples were centrifuged at 430 g for 10 minutes.…”

“…18,22–25 Briefly, 1 × 10 5 SVF cells were washed by 1 mL of binding buffer followed by centrifugation. After the supernatant removal, SVF cells were suspended in 100 µL of binding buffer with 10 µL of Annexin V-FITC or without (unstained control).…”

“…Lidocaine is the most widely used anesthetic in tumescent anesthesia. 14–17 However, our previous study 18 showed that lidocaine used in liposuction can have a negative impact on ASC survival. Currently for large-volume liposuction in conjunction with fat grafting, many patients undergo general anesthesia; therefore, lidocaine subcutaneous anesthesia may be considered nonessential.…”