Santiago, Chile From Hospital Clínico J. J. Aguirre; Clínica Alemana; Hospital Militar de Santiago; Clínica Santa María; Clínica Las Condes; Pontificia Universidad Católica de Chile; and Universidad de Chile.
Plast Reconstr Surg. 2013 Aug;132(2):327-332. doi: 10.1097/PRS.0b013e3182958b20.
Suction-assisted lipectomy is one of the most common procedures performed in plastic surgery. To minimize blood loss and to obtain adequate analgesia, a liquid solution is infiltrated into the subcutaneous plane before suction. The objective of this study was to determine whether the use of lidocaine in the infiltration solution reduces postoperative pain.
A prospective, randomized, double-masked, clinical trial was designed. Each side of patients' body zones to be treated with suction-assisted lipectomy was randomized to receive infiltration solution with or without lidocaine. Treatment allocation was performed using computer-generated random numbers in permuted blocks of eight. Pain was assessed using the visual analogue scale and registered 1, 6, 12, 18, and 24 hours after the procedure.
The trial was stopped after a first interim analysis. The use of lidocaine in the dilute solution reduced pain by 0.5 point on the visual analogue scale (95 percent CI, 0.3 to 0.8; p<0.001). The effect was independent of the suctioned body zone (p=0.756), and lasted until 18 hours after surgery. Its analgesic effect was lost at the 24-hour postoperative control. Pain increased an average of 0.018 point on the visual analogue scale per hour (95 percent CI, 0.001 to 0.036; p=0.043).
The use of lidocaine in the infiltration solution is effective in postoperative pain control until 18 hours after surgery. Nevertheless, its clinical effect is limited and clinically irrelevant, and therefore it is no longer used by the authors.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.
吸脂术是整形手术中最常见的手术之一。为了最大限度地减少出血并获得足够的镇痛效果，在抽吸前将液体溶液注入皮下平面。本研究的目的是确定浸润溶液中使用利多卡因是否能减轻术后疼痛。
设计了一项前瞻性、随机、双盲、临床试验。将接受吸脂术的患者身体区域的每一侧随机分为接受含有或不含有利多卡因的浸润溶液。使用计算机生成的随机数以 8 个为一组的置换块进行治疗分配。疼痛使用视觉模拟量表进行评估，并在手术后 1、6、12、18 和 24 小时进行登记。
第一次中期分析后，试验停止。在稀释溶液中使用利多卡因可使视觉模拟量表上的疼痛减轻 0.5 分（95%置信区间，0.3 至 0.8；p<0.001）。这种效果与抽吸的身体区域无关（p=0.756），并持续到手术后 18 小时。其镇痛效果在术后 24 小时的对照中消失。视觉模拟量表上的疼痛平均每小时增加 0.018 分（95%置信区间，0.001 至 0.036；p=0.043）。
在浸润溶液中使用利多卡因可有效控制术后疼痛，持续到手术后 18 小时。然而，其临床效果是有限的，临床上无关紧要，因此作者不再使用。
临床问题/证据水平：治疗，I。
