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DOI: 10.4103/0970-0358.146604
Electrolyte and Haemogram changes post large volume liposuction comparing two different tumescent solutions
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Publication History
Publication Date:
26 August 2019 (online)
ABSTRACT
Background: The most common definitions of large volume liposuction refer to total 5 l volume aspiration during a single procedure (fat plus wetting solution). Profound haemodynamic and metabolic alterations can accompany large volume liposuction. Due to paucity of literature on the effect of different tumescent solutions on the electrolyte balance and haematological changes during large volume liposuction, we carried out this study using two different wetting solutions to study the same. Materials and Methods: Total 30 patients presenting with varying degrees of localized lipodystrophy in different body regions were enrolled for the study. Prospective randomized controlled trial was conducted by Department of Plastic and Cosmetic Surgery, Sir Ganga Ram Hospital, New Delhi from January 2011 to June 2012. Patients were randomized into two groups of 15 patients each by using computer generated random numbers. Tumescent formula used for Group A (normal saline [NS]) was our modification of Klein’s Formula and Tumescent formula used for Group B (ringer lactate [RL]) was our modification of Hunstadt’s formula. Serum electrolytes and hematocrit levels were done at preinduction, immediate postoperative period and postoperative day 1. Result: Statistical analysis was performed using SPSS software version 15.0. Which showed statistically significant electrolytes and hematocrit changes occur during large volume liposuction. Conclusion: Statistically significant electrolytes and hematocrit changes occur during large volume liposuction and patients should be kept under observation of anaesthesist for at least 24 h. Patients require strict monitoring of vital parameters and usually Intensive Care Unit is not required. There was no statistical difference in the electrolyte changes using NS or RL as tumescent solution and both solutions were found safe for large volume liposuction.
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KEY WORDS
Electrolyte changes during liposuction - haemogram changes during liposuction - large volume liposuction
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Conflict of Interest
None declared.
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REFERENCES
- 1 Iverson RE, Lynch DJ. American society of plastic surgeons committee on patient safety. Plast Reconstr Surg 2004; 113: 1478-90
- 2 Trott SA, Beran SJ, Rohrich RJ, Kenkel JM, Adams Jr WP, Klein KW. Safety considerations and fluid resuscitation in liposuction: An analysis of 53 consecutive patients. Plast Reconstr Surg 1998; 102: 2220-9
- 3 Lipschitz AH, Kenkel JM, Luby M, Sorokin E, Rohrich RJ, Brown SA. Electrolyte and plasma enzyme analyses during large-volume liposuction. Plast Reconstr Surg 2004; 114: 766-75
- 4 Kenkel JM, Lipschitz AH, Luby M, Kallmeyer I, Sorokin E, Appelt E. et al. Hemodynamic physiology and thermoregulation in liposuction. Plast Reconstr Surg 2004; 114: 503-13
- 5 Basile AR, Fernandes F, Basile VV, Basile FV. Fluid resuscitation in liposuction: A prospective analysis of infiltrate-to-total aspirate ratios lower than used for the superwet technique. Aesthetic Plast Surg 2006; 30: 659-65
- 6 Jain AK, Khan AM. Stroke volume variation as a guide for fluid resuscitation in patients undergoing large-volume liposuction. Plast Reconstr Surg 2012; 130: 462e-9
- 7 Rao RB, Ely SF, Hoffman RS. Deaths related to liposuction. N Engl J Med 1999; 340: 1471-5
- 8 Platt MS, Kohler LJ, Ruiz R, Cohle SD, Ravichandran P. Deaths associated with liposuction: Case reports and review of the literature. J Forensic Sci 2002; 47: 205-7
- 9 Klein JA, Kassarjdian N. Lidocaine toxicity with tumescent liposuction A case report of probable drug interactions. Dermatol Surg 1997; 23: 1169-74
- 10 Grazer FM, de Jong RH. Fatal outcomes from liposuction: Census survey of cosmetic surgeons. Plast Reconstr Surg 2000; 105: 436-46
- 11 Oba H. Large-volume tumescent anesthesia for extensive liposuction in oriental patients: Lidocaine toxicity and its safe dose level. Plast Reconstr Surg 2003; 111: 945-6
- 12 Hetter GP. Blood and fluid replacement for lipoplasty procedures. Clin Plast Surg 1989; 16: 245-8
- 13 Commons GW, Halperin B, Chang CC. Large-volume liposuction: A review of 631 consecutive cases over 12 years. Plast Reconstr Surg 2001; 108: 1753-63
- 14 Toledo LS. Superficial syringe liposculpture. In: Toledo LS. (ed) Annals of the II International Symposium: Recent Advances in Plastic Surgery - RAPS/90. Sao Paulo, Brazil: 1990: p. 446
Address for correspondence:
-
REFERENCES
- 1 Iverson RE, Lynch DJ. American society of plastic surgeons committee on patient safety. Plast Reconstr Surg 2004; 113: 1478-90
- 2 Trott SA, Beran SJ, Rohrich RJ, Kenkel JM, Adams Jr WP, Klein KW. Safety considerations and fluid resuscitation in liposuction: An analysis of 53 consecutive patients. Plast Reconstr Surg 1998; 102: 2220-9
- 3 Lipschitz AH, Kenkel JM, Luby M, Sorokin E, Rohrich RJ, Brown SA. Electrolyte and plasma enzyme analyses during large-volume liposuction. Plast Reconstr Surg 2004; 114: 766-75
- 4 Kenkel JM, Lipschitz AH, Luby M, Kallmeyer I, Sorokin E, Appelt E. et al. Hemodynamic physiology and thermoregulation in liposuction. Plast Reconstr Surg 2004; 114: 503-13
- 5 Basile AR, Fernandes F, Basile VV, Basile FV. Fluid resuscitation in liposuction: A prospective analysis of infiltrate-to-total aspirate ratios lower than used for the superwet technique. Aesthetic Plast Surg 2006; 30: 659-65
- 6 Jain AK, Khan AM. Stroke volume variation as a guide for fluid resuscitation in patients undergoing large-volume liposuction. Plast Reconstr Surg 2012; 130: 462e-9
- 7 Rao RB, Ely SF, Hoffman RS. Deaths related to liposuction. N Engl J Med 1999; 340: 1471-5
- 8 Platt MS, Kohler LJ, Ruiz R, Cohle SD, Ravichandran P. Deaths associated with liposuction: Case reports and review of the literature. J Forensic Sci 2002; 47: 205-7
- 9 Klein JA, Kassarjdian N. Lidocaine toxicity with tumescent liposuction A case report of probable drug interactions. Dermatol Surg 1997; 23: 1169-74
- 10 Grazer FM, de Jong RH. Fatal outcomes from liposuction: Census survey of cosmetic surgeons. Plast Reconstr Surg 2000; 105: 436-46
- 11 Oba H. Large-volume tumescent anesthesia for extensive liposuction in oriental patients: Lidocaine toxicity and its safe dose level. Plast Reconstr Surg 2003; 111: 945-6
- 12 Hetter GP. Blood and fluid replacement for lipoplasty procedures. Clin Plast Surg 1989; 16: 245-8
- 13 Commons GW, Halperin B, Chang CC. Large-volume liposuction: A review of 631 consecutive cases over 12 years. Plast Reconstr Surg 2001; 108: 1753-63
- 14 Toledo LS. Superficial syringe liposculpture. In: Toledo LS. (ed) Annals of the II International Symposium: Recent Advances in Plastic Surgery - RAPS/90. Sao Paulo, Brazil: 1990: p. 446