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皮下利多卡因浸润对吸脂术所致失血的影响:一项前瞻性、随机、双盲临床试验。

Effect of subcutaneous lidocaine infiltration on blood loss secondary to corporal lipoaspiration: a prospective, randomized, double-masked clinical trial.

机构信息

Llanos Subercaseaux 2959, Depto 1001, San Miguel, Chile.

出版信息

Aesthetic Plast Surg. 2009 Sep;33(5):738-42. doi: 10.1007/s00266-009-9343-y. Epub 2009 May 30.

DOI:10.1007/s00266-009-9343-y
PMID:19484178
Abstract

BACKGROUND

Lipoaspiration is one of the most frequently performed aesthetic surgical procedures worldwide. The use of tumescent solution containing lidocaine to infiltrate subcutaneous fat before surgery has been accepted as the standard of care for these procedures. Its objective is to diminish postoperative analgesic necessities and secondary blood loss, but its role in hematocrit reduction is not clear at this time. This study aimed to measure the effect of subcutaneous lidocaine infiltration on blood loss secondary to corporal liposuction.

METHODS

A prospective, randomized, double-masked clinical trial was performed. Between November 2005 and July 2007, 70 consecutive female patients submitted to corporal liposuction as a single surgery were included in the study. All the patients were randomly assigned to two groups. The study group received tumescent solution containing lidocaine and epinephrine, whereas the control group received tumescent solution containing only epinephrine. Hematocrit was measured preoperatively, then 2 to 4, 12, and 24 h postoperatively.

RESULTS

The comparison between the two groups did not show significant statistical differences with respect to age, body mass index, infiltrated volume, aspirated fat volume, surgical time, hospital stay, preoperative hematocrit, or comparison of the areas lipoaspirated. The mean hematocrit reduction in the study group was 10.8% +/- 2.9% compared with 8.8% +/- 2.6% in the control group (P = 0.004).

CONCLUSION

The use of lidocaine in the tumescent solution for subcutaneous fat infiltration significantly increases postoperative anemia compared with the results obtained when epinephrine infiltration alone is used.

摘要

背景

吸脂术是世界范围内最常施行的美容手术之一。在手术前使用含利多卡因的肿胀液浸润皮下脂肪,已被认为是这些手术的标准护理方法。其目的是减少术后止痛的需要和二次失血,但目前尚不清楚其在降低血细胞比容方面的作用。本研究旨在测量皮下利多卡因浸润对躯体吸脂术继发失血的影响。

方法

进行了一项前瞻性、随机、双盲临床试验。2005 年 11 月至 2007 年 7 月,70 例连续女性患者接受了单一躯体吸脂术,被纳入了本研究。所有患者被随机分配到两组。实验组接受含利多卡因和肾上腺素的肿胀液,而对照组仅接受含肾上腺素的肿胀液。术前、术后 2-4 小时、12 小时和 24 小时测量血细胞比容。

结果

两组之间在年龄、体重指数、浸润量、抽吸脂肪量、手术时间、住院时间、术前血细胞比容或抽吸面积方面均无显著统计学差异。实验组的平均血细胞比容降低为 10.8% +/- 2.9%,而对照组为 8.8% +/- 2.6%(P = 0.004)。

结论

与单独使用肾上腺素浸润相比,肿胀液中利多卡因的使用会显著增加术后贫血。

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