Klein JA.
Anesthesia for liposuction in dermatologic surgery.
J Dermatol Surg Oncol. 1988 Oct;14(10):1124-32.

Department of Dermatology, California College of Medicine, University of
California, Irvine.

Liposuction is now a well-established procedure in dermatologic surgery. The
relative advantages and risks of the various forms of primary anesthesia and
supplemental analgesia used for liposuction surgery in the office by
dermatologic surgeons is described. Effective anesthetic techniques include
infiltration of local anesthesia (LA) with or without intramuscular (IM),
intravenous (IV), or nitrous oxide sedation, cryoanesthesia, and IV or
inhalation general anesthesia (GA). Local anesthesia, using large volumes of
dilute anesthetic solution containing lidocaine (0.05%), epinephrine
(1:1,000,000), and sodium bicarbonate (12.5 meq/L), is a safe and effective
modality for liposuction by dermatologists. In a study of 12 liposuction
patients treated with this technique, the average lidocaine dose was 1181 mg
(9.4 mg/kg/hr). The highest peak lidocaine blood level among all patients was
0.484 microgram/ml. Dermatologists should not assume the dual responsibility of
surgeon and of monitoring patients given IV sedation. Any form of anesthesia has
the potential for serious complications. The surgeon and office staff must be
well trained and equipped to perform emergency resuscitation.

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