Aktas Yildirim Serap, Dogan Lerzan, Sarikaya Zeynep Tugce, Gucyetmez Bulent, Demirtas Yener, Toraman Fevzi
Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul 34752, Turkey.
Department of Anesthesiology and Reanimation, Acibadem Altunizade Hospital, Istanbul 34662, Turkey.
J Pers Med. 2024 May 7;14(5):494. doi: 10.3390/jpm14050494.
The use of wetting solutions (WSs) during high-volume liposuction is standard; however, the optimal amount of WS and its components and their effect on postoperative complications are unclear. We evaluated the effect of a WS and its components, calculated according to ideal body weight (IBW), on postoperative complications.
High-volume liposuction with a WS containing 0.5 g of lidocaine and 0.5 mg of epinephrine in each liter was performed in 192 patients. Patients who received ≤90 mL/kg of WS were designated as group I and those who received >90 mL/kg of WS as group II. Postoperative complications and adverse events that occurred until discharge were recorded.
The mean total amount of epinephrine in the WS was significantly higher for group II (3.5 mg; range, 3.0-4.0 mg) than for group I (2.0 mg; range, 1.8-2.5 mg; < 0.001), as was the mean total amount of lidocaine (3.5 g [range, 3.5-4.3 g] vs. 2.0 g [range, 1.8-2.5 g], respectively; < 0.001). No major cardiac or pulmonary complications occurred in either group. Administration of >90 mL/kg of WS increased the median risk of postoperative nausea 5.3-fold (range, 1.8- to 15.6-fold), that of hypertension 4.9-fold (range, 1.1- to 17.7-fold), and that of hypothermia 4.2-fold (range, 1.1- to 18.5-fold). The two groups had similar postoperative pain scores and blood transfusion rates.
The risks of postoperative nausea, vomiting, hypothermia, and hypertension may increase in patients who receive >90 mL/kg of WS calculated according to IBW during high-volume liposuction.
在大容量抽脂术中使用湿润溶液(WSs)是标准操作;然而,WS的最佳用量及其成分以及它们对术后并发症的影响尚不清楚。我们评估了根据理想体重(IBW)计算的WS及其成分对术后并发症的影响。
对192例患者进行大容量抽脂术,使用每升含0.5克利多卡因和0.5毫克肾上腺素的WS。接受WS量≤90毫升/千克的患者被指定为I组,接受WS量>90毫升/千克的患者为II组。记录直至出院时发生的术后并发症和不良事件。
II组WS中肾上腺素的平均总量(3.5毫克;范围3.0 - 4.0毫克)显著高于I组(2.0毫克;范围1.8 - 2.5毫克;P < 0.001),利多卡因的平均总量也是如此(分别为3.5克[范围3.5 - 4.3克]对2.0克[范围1.8 - 2.5克];P < 0.001)。两组均未发生重大心脏或肺部并发症。给予>90毫升/千克的WS使术后恶心的中位风险增加5.3倍(范围1.8 - 15.6倍),高血压风险增加4.9倍(范围1.1 - 17.7倍),体温过低风险增加4.2倍(范围1.1 - 18.5倍)。两组术后疼痛评分和输血率相似。
在大容量抽脂术中,接受根据IBW计算>90毫升/千克WS的患者术后恶心、呕吐、体温过低和高血压的风险可能会增加。