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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Local Anesthetics: Common Agents and Their Applications01:23

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Related Experiment Video

Updated: Mar 15, 2026

Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata
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Tumescent Liposuction without Lidocaine.

Joshua J Goldman1, Wei Z Wang1, Xin-Hua Fang1

  • 1Division of Plastic Surgery, Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nev.

Plastic and Reconstructive Surgery. Global Open
|September 14, 2016
PubMed
Summary

Removing lidocaine from tumescent anesthesia significantly improves adipose-derived stem cell (ASC) and stromal vascular fraction (SVF) survival during liposuction. This finding is crucial for procedures utilizing lipoaspirate for fat grafting.

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Area of Science:

  • Regenerative Medicine
  • Stem Cell Biology
  • Plastic Surgery

Background:

  • Previous research indicated lidocaine negatively impacts adipose-derived stem cell (ASC) survival.
  • General anesthesia is common in large-volume liposuction, making lidocaine tumescent anesthesia potentially unnecessary.
  • The study investigated if omitting lidocaine from tumescent solution enhances stromal vascular fraction (SVF) and ASC survival.

Purpose of the Study:

  • To evaluate the impact of lidocaine in tumescent anesthesia on SVF and ASC survival.
  • To compare the efficacy of tumescent anesthesia with and without lidocaine.
  • To assess the cytotoxic effects of ropivacaine on ASCs.

Main Methods:

  • Liposuction was performed on bilateral body areas in 10 adult patients under general anesthesia.
  • One side received standard tumescent with lidocaine; the contralateral side received tumescent without lidocaine.
  • SVF was isolated, and adherent ASCs were cultured and quantified; apoptosis and necrosis were analyzed via flow cytometry.

Main Results:

  • The no-lidocaine group showed significantly higher live SVF cell percentages (86.7% vs. 68.0%) and lower apoptosis rates.
  • Viable ASC counts were significantly greater in the no-lidocaine group (500,000 vs. 367,000).
  • No significant difference in ASC cytotoxicity was observed between lidocaine and ropivacaine.

Conclusions:

  • Omitting lidocaine from tumescent solution significantly reduces SVF and ASC apoptosis in liposuction aspirate.
  • Tumescent liposuction without lidocaine is recommended, especially when lipoaspirate is intended for fat grafting.
  • Further research may explore alternative local anesthetics and their effects on stem cell viability.