Tumescent liposuction: efficacy of a lower lidocaine dose (400 mg/l)

Local anesthesia has been widely accepted as the standard of care in liposuction. Anesthesia is achieved with a standard tumescent solution, and lidocaine is most often used at a concentration of 500 mg/l.

To evaluate the efficacy of a 400 mg/l lidocaine concentration in tumescent liposuction.

We performed a randomized clinical trial on 200 consecutive patients undergoing lipoaspiration. Patients were divided into two groups: group A (n = 100) received tumescent solution with a lidocaine concentration of 500 mg/l, in group B (n = 100) lidocaine levels were reduced to 400 mg/l. Pain was assessed twice during the procedure, at infiltration and while liposuction was performed. Patients rated their pain level on a numeric rating scale from 0 to 10, with 10 being the worst possible pain.

Tumescent solution containing a lidocaine concentration of 400 mg/l provided effective local anesthesia during lipoaspiration. There was no statistically significant difference in the pain level between the two groups.

We propose the use of a lower lidocaine concentration of 400 mg/l in the tumescent solution compared to the originally described solution containing 500 mg/l. This is of particular interest when multiple body parts or larger areas are to be treated to avoid lidocaine toxicity.