The Tumescent Technique for Liposuction Surgery

Lillis, Patrick J.

doi:10.1016/s0733-8635(18)30475-3

Cited by 76 publications

(25 citation statements)

References 25 publications

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“…One such factor is PKC-x/l as it has been suggested that PKC-x might have a role in both adipogenesis and increased glucose effectiveness. 25 Further studies are needed to confirm that a difference in glucose effectiveness is indeed present, and to determine the time course for these changes. The acute effect seen on IL-6, adiponectin, and angiotensin II has not been previously described.…”

Section: Discussionmentioning

confidence: 99%

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Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

2006

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Objective: The most common surgical procedure for obesity is liposuction, the majority of which are small-volume procedures. The effect of large-volume liposuction on cardiovascular risk and insulin sensitivity has been variable. This study was performed to evaluate the effect of the more common, smaller-volume liposuction on insulin sensitivity, inflammatory mediators, and cardiovascular risk factors. Subjects and study design: In all, 15 overweight or obese premenopausal women underwent metabolic evaluation prior to, 1 day following and 1 month following suction lipectomy of the abdomen. Metabolic evaluation included assessment of free fatty acids, glucose, insulin, insulin sensitivity by frequently sampled i.v. glucose tolerance test, and adipokines (IL-6, angiotensin II, leptin, PAI-1, adiponectin, and TNF-a). Results: Free fatty acids did not change acutely although there was an almost 30% decrease in free fatty acids at 1 month. Fasting insulin levels decreased at one month from 8.371.1 to 5.671.3 mU/ml (P ¼ 0.006). Insulin sensitivity by i.v. glucose tolerance test did not change at 1 month (4.070.8 to 5.070.7, P ¼ 0.12) although with subgroup analysis insulin sensitivity improved in obese but not overweight participants. Several adipokines worsened acutely (IL-6 increased 15 fold and angiotensin II increased 67%), but there was no change in PAI-1, and other adipokines (adiponectin, leptin, and TNF-a) decreased. At the 1-month follow-up, all adipokines were similar to baseline. Conclusion: This study provides little evidence supporting increased or decreased cardiovascular risk although there is evidence supporting improved insulin sensitivity at one month, especially in obese women.

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Section: Discussionmentioning

confidence: 99%

“…24 Suction lipectomy of the abdomen was then performed. 25 Preoperative sedation with 1-2 mg lorazapam and 0.1 mg clonidine was administered to all participants (one participant did not receive clonidine but was included as there were no differences in metabolic data). The abdomen was marked and preoperatively photographed.…”

Section: Methodsmentioning

confidence: 99%

Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

2006

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“…Die Anwendung wurde erweitert durch die Erfahrung, daß Lokalanästhetika auch in größerer Verdünnung an der Haut wirksam sind und daß in Kombination mit Adrenalin höhere Dosierungen als bisher angenommen tolerabel sind, da Lokalanästhetika zunächst im subkutanen Gewebe gebunden werden [5,9,12]. Diese Tumeszenzanästhesie genannte Methode wurde bisher vorwiegend für die Liposuktion verwendet [6,8,10], in letzter Zeit aber auch für Venenstrippingoperationen, Dermabrasionen und eine Reihe weiterer Hautoperationen wie z.B. Lappenplastiken [1][2][3][4]7].…”

Section: Geräteausstattung: Handelsüblicheunclassified

Subkutane Infusionsan�sthesie (SIA) mit durch Ringer-L�sung verd�nntem Prilocain

Breuninger

Wehner‐Caroli

1998

Der Hautarzt

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“…Other surgeons [28][29][30][31] have reported similar experience with such high doses as 40 mg/kg [32] of lidocaine, some patients needing higher doses than others. Recently Hunstad [33] reported his technique and constructed a graph to determine the volume at which the maximum 35 mg/kg dosage recommended by Klein occurred (see Fig.…”

Section: Maximal Dose Of Lidocainementioning

confidence: 99%

The tumescent technique revisited

Bussien¹,

Maillard²

1996

Eur J Plast Surg

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In the history of suction-assisted lipectomy, ultrasonic liposculpture and body contouring procedures, Klein's formula for the tumescent technique represents an important milestone. Since 1987 the formula has been altered by other clinicians. Although initially created for outpatient surgery without the services of an anesthetist, the technique is nowadays used so frequently that it cannot any longer be considered as a minor office procedure. It is useful to examine the ingredients of the various formula used in order to justify their use. This paper contains five sections. Part one deals with the fluid required by the various authors. Water and electrolytes exchanges in relation to the interstitial compartment are reviewed. Part two considers local anesthetics, their toxicity and the maximum safe dose. Part three considers the controversy on epinephrine. Part four comments on the addition of sodium bicarbonate to the solution. Part five explains why infiltration of chilled solutions is inappropriate. The following regimen is advised as a result of the above studies: lactated Ringer's solution is the fluid of choice; lidocaine: 500 rag/1 as the reference anesthetic. The maximum safe dose recommended for liposuction is 35 mg/kg over 45 rain (PDR recommendations: 7 mg/kg). Epinephrine: 1 rag/1. Prospective studies ought to be done on the topic: Sodium bicarbonate 8.4%: 5 MEq/1 (optional). Higher doses are of no value but are not harmless. The fluids to be infiltrated at room temperature rather than chilled.

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The Tumescent Technique for Liposuction Surgery

Cited by 76 publications

References 25 publications

Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk

Subkutane Infusionsan�sthesie (SIA) mit durch Ringer-L�sung verd�nntem Prilocain

The tumescent technique revisited

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