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Analgesic Efficacy of Lidocaine for Suction-Assisted Lipectomy with Tumescent Technique under General Anesthesia: A Randomized, Double-Masked, Controlled Trial

Danilla, Stefan M.D., M.Sc.; Fontbona, Montserrat M.D.; de Valdés, Victoria Diaz M.D.; Dagnino, Bruno M.D.; Sorolla, Juan Pablo M.D.; Israel, Guillermo M.D.; Searle, Susana M.D.; Norambuena, Hernán M.D.; Cabello, Rodrigo M.D.

Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e3182958b20
Cosmetic: Original Articles
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.

Author Information

Santiago, Chile

From Hospital Clínico J. J. Aguirre; Clínica Alemana; Hospital Militar de Santiago; Clínica Santa María; Clínica Las Condes; Pontificia Universidad Católica de Chile; and Universidad de Chile.

Received for publication October 8, 2012; accepted February 27, 2013.

Presented at XII Congreso de Cirugía Plástica del Cono Sur Americano and XI Congreso Chileno de Cirugía Plástica, in Viña del Mar, Chile, October 11 through 14, 2009.

This trial is registered under the name “Safety and Efficacy of Lidocaine Infiltration in Suction Assisted Lipectomy,” ClinicalTrials.gov identification number NCT00591487 (http://clinicaltrials.gov/ct2/show/NCT00591487).

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Stefan Danilla, M.D., M.Sc. Santos Dumont 999 Hospital Clínico Universidad de Chile Sector B, 3er piso, Departamento de Cirugía Independencia Santiago, Chile drstefandanilla@gmail.com

©2013American Society of Plastic Surgeons