Wetting Solution-ideal Body Weight Ratio in Liposuction Procedures

Overview

Although the use of wetting solutions during high-volume liposuction is a standard approach, it is unclear how to optimize wetting solutions and components and their effect on postoperative complications.. Since the super-wet technique (aspiration of 1 cc per 1 cc of infiltrate) was introduced in 1986, it has become one of the most frequently applied techniques worldwide . Adrenaline and lidocaine are often added to WS due to their hemostatic and analgesic effects One of the major advantages of super-wet technique is that blood loss is quite low. However, potential cardiovascular side effects of WS and the amounts of epinephrine and lidocaine they contain, such as volume overload, local anesthetic toxicity, hypertension, arrhythmia, and tachycardia, are still a scoop of investigation. In this study, we examined the WS and the medications it contains from a different perspective to understand the possible cause of these adverse outcomes. Despite the most suitable candidates for liposuction are patients with a BMI\<30 kg/m2 and low comorbidity and age, the patient group undergoing liposuction is often obese, and overweight individuals require that obesity-related pathophysiological changes be taken into consideration. Therefore, we analyzed the patients by dividing them into two groups according to the amount of WS applied according to their IBW (WS/IBW≤90ml/kg: group I and WS/IBW\>90ml/kg: group I). In this study we aimed to evaluate the effect of wetting solutions and components calculated according to ideal body weight (IBW) on postoperative complications

Liposuction is one of the most popular aesthetic surgical procedures worldwide making it possible to remove a significant amount of adipose tissue. Generally, liposuction is seen as a benign minor operation, but it can be considered a major surgery due to risk factors such as long operation times, intraoperative volume shifts, hypothermia, usage of high-dose adrenaline and lidocaine in wetting solution (WS), and possibly cardiac or pulmonary fatal complications. Therefore, anesthesiologists and plastic surgeons need to be aware of the intraoperative and postoperative pathophysiological changes caused by liposuction. In the literature, large-volume liposuction is defined as the removal of more than 5 liters of lipoaspirate in a single procedure. The most suitable candidates for liposuction are individuals with BMI\<30 kg/m2, but large-volume liposuction is applied more frequently to overweight and obese individuals. However, obesity can cause pathophysiological changes. In particular, increased cardiac output and changes in distribution volume may affect the pharmacokinetics and pharmacodynamics of drugs. Medications administered according to actual body weight (ABW) may lead to adverse outcomes due to overdose. For this reason, some approaches recommend adjusting perioperative medications according to IBW instead of ABW. The effects of WS and its components used in liposuction on patient outcomes have been examined in many studies, but the IBWs of the patients have not been taken into consideration. This study aimed to examine the effect of WSs calculated according to the IBW on postoperative complications and adverse events.