VASER Liposuction - How to Get Natural Results with Ultrasound Assisted Liposuction?

Bagatin, Dinko; Bagatin, Tomica; Deutsch, Judith; Šakić, Katarina; Johann, Nemrava; Isomura, Eduardo; Ivelj, Martina Šarec

doi:10.5772/intechopen.100154

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…Blanching is used to estimate tissue analgesia. At a centre using VASER (Vibration Amplification of Sound Energy at Resonance) liposuction, tumescent is slowly infiltrated (0.05 mg/ml bupivacaine and 0.14 µg/ml epinephrine in buffered 0.9 per cent saline at 100.0 ml/min) 48 . They wait a further 5.0–6.0 min in the neck, and 10.0–15.0 min in the rest of the body, before starting.…”

Section: Resultsmentioning

confidence: 99%

How long to wait after local infiltration anaesthesia: systematic review

Bajwa,

Bashir,

Bajwa

et al. 2023

BJS Open

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Background Conflicting evidence exists regarding the optimal waiting time for stable analgesic and vasoconstrictive effects after local infiltration of lidocaine with epinephrine. An objective review is needed to dispel surgical dogma. Methods This systematic review (PROSPERO ID: CRD42022362414) included RCTs and prospective cohort studies. Primary outcomes were (1) onset of analgesia and (2) onset of stable hypoperfusion, assessed directly, or measured indirectly using perfusion imaging. Other data extracted include waiting strategies, means of outcome assessment, anaesthetic concentrations, volume/endpoint of infiltration, and injection sites. Methodological quality was evaluated using the Cochrane risk-of-bias tool for randomized trials. Articles describing waiting strategies were critically appraised by the Joanna Briggs Institute tools. Results Twenty-four articles were analysed, comprising 1013 participants. Ten investigated analgesia onset. Their pooled mean was 2.1 min (range 0.4–9.0 min). This varied with anatomic site and targeted nerve diameter. Fourteen articles investigated onset of stable hypoperfusion. Four observed bleeding intraoperatively, finding the minimum time to hypoperfusion at 7.0 min in the eyelid skin and 25.0 min in the upper limb. The ten remaining studies used perfusion imaging, reporting a wide range of results (0.0–30.0 min) due to differences in anatomic sites and depth, resolution and artefacts. Studies using near-infrared reflectance spectroscopy and hyperspectral imaging correlated with clinical observations. Thirteen articles discussed waiting strategies, seven relating to large-volume tumescent local infiltration anaesthesia. Different waiting strategies exist for emergency, arthroscopic and cosmetic surgeries, according to the degree of hypoperfusion required. In tumescent liposuction, waiting 10.0–60.0 min is the norm. Conclusion Current literature suggests that around 2 min are required for most patients to achieve complete analgesia in all sites and with all anaesthesia concentrations. Waiting around 7 min in eyelids and at least 25 min in other regions results in optimal hypoperfusion. The strategies discussed inform decisions of when and how long to wait.

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Section: Resultsmentioning

confidence: 99%

How long to wait after local infiltration anaesthesia: systematic review

Bajwa,

Bashir,

Bajwa

et al. 2023

BJS Open

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“…As seen from the table and graph, the prone position is used for total body liposuction (with or without abdominoplasty). The operations usually begin on the backside of the patient and following completion, the patients are turned around to complete the frontside [19,20]. At this point, following roation, a decision will be made to the length of the procedure, whether to keep the i-gel in place for the remainder of the operation, or if an ET tube will be placed.…”

Section: Induction For Esthetic Plastic Proceduresmentioning

confidence: 99%

Anesthesia in Plastic Surgery: Intersurgical I-gel Placement in a Prone Position

Deutsch¹,

Šakić²,

Bagatin³

et al. 2023

Updates in Anesthesia - The Operating Room and Beyond

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Anesthesia is a specialization which in past history has branched off of surgery. It needs to be very creative in its delivery, in order to accommodate the many operating positions, needed by the surgeon. The patient positions must also be safe and adequate for proper ventilation, throughout the operative procedure. There are times when multiple positions must be used, turning the patient over, even several times. Careful planning and team discussions prior to an operation are absolutely necessary, to form anesthetic and operative plans. The aim of the supraglottic airway device (Intersurgical i-gel) prone position induction method is to describe, detail and present its safe efficacy for certain planned operative procedures. Patient fasting preparation is a must, nil by mouth for 8 h. This method and sequence alleviates the use of muscle relaxants for patient rotation. This increases patient safety by keeping muscle tone normal, reduced drug use, minimizing rotation of the patient, and reduces possible injury of patient and among staff involved in rotating. Some may say induction in the prone position may be unsafe due to aspiration risks, but knowing anatomy and gravitational physics, in the event of any secretions projected, they will project forwards onto the operating table (through the gastric port of the i-gel), not into the tracheal area. This similar technique and principle are seen and used for the recovery position, to aid in free drainage of fluid from within the oral cavity. The method is used for a variety of operations worldwide and introduced in 2018 at Poliklinika Bagatin (PB). Approximately, 80 prone position inductions or 10% of all general anesthesias are performed every year at PB. More than 240 anesthesized patients in the prone position with an i-gel have used this method, since it was introduced. All have been with excellent results, minimal risk and appropriate ventilation of patients. I-gel placement in prone position was successful everytime. This method is advantageous to avoid multiple rotations of patients and avoid the use of muscle relaxants, otherwise used, with classic endotracheal intubation methods. The exact process will be discussed in more detail and described within the chapter.

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VASER Liposuction - How to Get Natural Results with Ultrasound Assisted Liposuction?

Cited by 2 publications

References 27 publications

How long to wait after local infiltration anaesthesia: systematic review

How long to wait after local infiltration anaesthesia: systematic review

Anesthesia in Plastic Surgery: Intersurgical I-gel Placement in a Prone Position

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