J Drugs Dermatol. 2021 Mar 1;20(3):326-334. doi: 10.36849/JDD.5828.
Lipedema is a chronic, progressive disease that occurs almost exclusively in women and leads to pathological, painful fat growths at the extremities. Only symptomatic therapy can be offered since the etiology of the disease has not yet been clarified. Liposuction in tumescent anesthesia has established itself as a surgical treatment method of choice. The complication rate associated with the procedure and the pharmacological course and safety of treatment in patients with lipedema has not yet been sufficiently studied. The aim of the study was to broaden the evidence on the safety of ambulatory high-volume liposuction in tumescent anesthesia in lipedema patients. Influencing factors of patients (weight, fat content, comorbidities) or the process technique (drug administration, volume of aspirates) should be investigated on the safety and risks of tumescent anesthesia. This was a retrospective data analysis in which data from 27 patients (40 liposuction procedures) treated at the Sandhofer and Barsch lipedema center between 2016 and 2018 were evaluated. The liposuctions were carried out in tumescent anesthesia and using a Power-Assisted Liposuction system. Clinical examinations and regular blood samples were carried out before the procedure, intra- and postoperatively. The procedures lasted an average of 118 minutes and an average of 6111 ml of aspirate was removed. For tumescent anesthesia, patients were given an average lidocaine dose of 34.23 mg/kg body weight and an epinephrine dose of 0.11 mg/kg body weight. No relevant complications associated with drug side effects, hypovolemia or hypervolemia or blood loss were detected. Liposuction under high volume tumescent anesthesia for the treatment of lipedema patients is, even for major intervention, a safe procedure. J Drugs Dermatol. 2021;20(3):326-334. doi:10.36849/JDD.5828.
脂肪水肿是一种几乎仅发生于女性的慢性、进行性疾病，可导致四肢出现病理性、疼痛性脂肪生长。由于该病的病因尚未明确，因此只能提供对症治疗。肿胀麻醉下的吸脂术已成为首选的手术治疗方法。但与该手术相关的并发症发生率以及脂肪水肿患者的药物治疗过程和安全性尚未得到充分研究。本研究旨在扩大肿胀麻醉下门诊大容量吸脂术治疗脂肪水肿患者的安全性证据。应研究患者的影响因素（体重、体脂含量、合并症）或手术技术（药物给药、抽吸量）对肿胀麻醉的安全性和风险的影响。这是一项回顾性数据分析，评估了 2016 年至 2018 年期间在 Sandhofer 和 Barsch 脂肪水肿中心接受治疗的 27 名患者（40 例吸脂术）的数据。吸脂术在肿胀麻醉下进行，并使用 Power-Assisted Liposuction 系统。在手术前、手术中和手术后进行临床检查和定期采血。手术平均持续 118 分钟，平均去除 6111ml 抽吸物。肿胀麻醉中，患者平均给予 34.23mg/kg 体重的利多卡因和 0.11mg/kg 体重的肾上腺素。未发现与药物副作用、低血容量或高血容量或失血相关的任何相关并发症。大容量肿胀麻醉下吸脂术治疗脂肪水肿患者，即使是大手术，也是一种安全的手术。J Drugs Dermatol. 2021;20(3):326-334. doi:10.36849/JDD.5828.
