Issues and Surgical Planning of Large Volume Liposuction

LONDON - June 16, 2015 - PRLog -- Aneasthesia Management

The anaesthsia is one of the basic ideals in the surgical planning of liposuction surgery, more so in case of large volume fat removal it is big of a challenge for anaesthesiologists and pathophysiologists in the surgical team.  Of the four major techniques of anaesthesia— dry, wet, super wet and local anaesthesia with epinephrine, the dry technique is now outdated. Of the three actively practiced techniques till date, general anaesthesia and with local anaesthesia with epinephrine; or local anaesthesia with IV sedation are the most commonly performed techniques.

The dilution combines local anaesthesia and epinephrine injected into the treatable area to numb the area and vasoconstriction, while the general anaesthesia is used to relax the patient.

Vasocontriction— the epinephrine diluted with the local anaesthesia has the properties to constrict blood vessels and capillaries. Once injected subcutaneously it can stiffen and expand the treatable area under a regional anaesthesia principle.

If the volume of the local anaesthesia is greater than the total fat targeted to be removed, it is called super wet, if it is equal, it is wet. The volume of the local anaesthesia is a major concern, which is anything more than 35-55miligrams per kilo of fat. The major concern is about anaesthetic toxicity, which can cause disorientation, disorientation, dizziness, lightheadedness, metallic taste to the toungue, higher risks can be cardiovascular arrest and even coma. However, the higher risks are very rare, almost 1 to 500,000, which is next to none. But in medical practice, “no risks” is never considered.

Intra-operative Fluid Management and Hemodynamic Monitoring

The administration of a large volume local anaesthetic requires careful intra-operative fluid and hemodynamic monitoring, and thermoregulation (temperature control). During the aspiration, the anaesthesia isalso drained out of the body along with the fat, bodily fluids and some blood. Because a large amount of bodily fluids is drained out in an unnatural and sudden way, intra-operative fluid administration manages the invasiveness through saline. It cannot be assessed as to how much blood has the patient lost, since it is mixed with the fat and bodily fluid.

Does Power Assisted Liposuction Make Any Difference?

Power assisted or automated workstations, like Ultrasound Vaser Liposuction (http://www.harleybodyclinic.co.uk/), Laser assisted Smart Lipo amongst a plethora of other mechanisms are widely developed to make surgical fat removal more selective and lesser invasive. However, it doesn’t introduce any new technique to the course of the procedure; the main focus is to relieve the strain during the process when the fat is separated from the surrounding tissues under skin layers of the treatable area. But in terms of anaethetic and fluid management, theroregulation, VASER Lipo, Smar Lipo or any other mechanism do not make any difference.

Not For Obesity Management

Liposuction, despite being a fat removal surgery is not designed or achievable for weight reduction, but body contouring. Hence it can only be a part of obesity management or weight reduction treatment and not a standalone solution. Even large volume liposuction doesn’t have any purpose in weight reduction it is just remove those superficial fats which is unreachable with weight reduction surgeries like bariatric surgery, or organic mean of dieting and exercising.