Analgesic efficacy of lidocaine for suction-assisted lipectomy with tumescent technique under general anesthesia: a randomized, double-masked, controlled trial.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

• Authors: Stefan Danilla, Montserrat Fontbona, Victoria Diaz de Valdés, Bruno Dagnino, Juan Pablo Sorolla, Guillermo Israel, Susana Searle, Hernán Norambuena, Rodrigo Cabello
• Journal: Plastic and reconstructive surgery (Plast Reconstr Surg) Vol. 132 Issue 2 Pg. 327-332 (Aug 2013) ISSN: 1529-4242 [Electronic] United States
• PMID: 23897332 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anesthetics, Local
• Lidocaine

Topics

• Adolescent
• Adult
• Anesthesia, General (methods)
• Anesthetics, Local (administration & dosage)
• Confidence Intervals
• Double-Blind Method
• Female
• Humans
• Injections, Intralesional
• Intraoperative Care (methods)
• Lidocaine (administration & dosage)
• Lipectomy (adverse effects, methods)
• Male
• Pain Measurement
• Pain, Postoperative (prevention & control)
• Prospective Studies
• Reference Values
• Risk Assessment
• Treatment Outcome
• Young Adult