Anesthesia for Liposuction Surgery

BMI greater than 30 kg/m². Classified as obese.

Removing fat via suction using a cannula.

Solution used in liposuction, may include additives.

A measurement of body fat based on height and weight.

BMI greater than 40 kg/m². Indicates severe obesity.

Medications taken before surgery can affect anesthesia, potentially causing complications like irregular heartbeats or breathing problems.

Monoamine oxidase inhibitors (MAOIs) increase norepinephrine, affecting the nervous system and potentially leading to high blood pressure or drowsiness.

Obesity increases the risk of complications during and after liposuction, linked to conditions like diabetes, high blood pressure, and sleep apnea.

Obstructive sleep apnea (OSA) is common in obese patients, increasing respiratory risks during and after procedures.

Obesity strains the heart, leading to increased workload, high blood pressure, and potentially heart enlargement.

Obesity can increase the risk of aspiration (food/fluid entering the lungs) due to factors like hiatal hernia and reduced stomach emptying.

Opioids and sedatives used after surgery increase the risk of difficulty breathing after liposuction in obese patients.

Increased risks for perioperative complications for patients with BMI > 20%.

Administering antibiotics before liposuction surgery to prevent infections, like necrotizing fasciitis, by targeting bacteria like Streptococcus pyogenes and Staphylococcus aureus.

The prone position in surgery (lying on stomach) can cause decreased cardiac output, breathing difficulties, and potential brain problems due to blood flow issues.

Patient (age, health status, existing conditions), surgery (length of operation, tools), and procedures (patient care) can raise the probability of liposuction infections.

Ideally, administering prophylactic antibiotics within 60 minutes of the surgical cut.

In the prone position, abdominal muscle pressure reduces blood flow to vital organs, like the heart.

Liposuction performed without pre-treatment of the area with fluids.

Liposuction involving infiltration of a solution (e.g., with or without additives) to the operative site before suctioning.

Liposuction using a large volume of dilute lidocaine solution to numb and swell the tissue before suctioning.

Epinephrine in the infiltration solution can significantly reduce blood loss during liposuction while aiding in hemostasis.

Dry liposuction procedures have a higher risk of blood loss (20%–45%), potentially requiring transfusion, especially with high aspirate volumes.

Closely monitoring IV fluids, wetting solution, aspirate, blood loss, and urine output to maintain fluid balance during liposuction.

Patients with more than 4 liters of fat and fluid removed during liposuction should receive only maintenance fluids, plus additional maintenance fluids calculated per mL of aspirate over 4L.

Established guidelines defining how much fluid a patient requires given the aspirate and possible blood loss during and after liposuction; there are currently few definitive standards.

About 60-70% of the wetting solution used during liposuction is absorbed into the tissues, not removed.

In the tumescent technique, approximately 1% of the aspirate volume is typically lost in the form of blood.

Symptoms from high levels of lidocaine in the blood, affecting the nervous system, and potentially leading to seizures or heart problems.

Lidocaine is mainly processed by the liver, with a maximum processing capacity. The process is affected by liver health and blood flow.

Epinephrine added to liposuction solutions reduces lidocaine absorption and helps control bleeding.

Early symptoms of local anesthetic toxicity include ringing in the ears, numbness around the lips, and dizziness. More severe symptoms include loss of consciousness and cardiac arrest.

Total blood loss in liposuction is calculated by multiplying the percentage of blood in the aspirate by the total volume suctioned.

The liver is the primary organ for metabolizing lidocaine, directly impacting its plasma levels.

Liposuction technique using large quantities of dilute lidocaine solution to numb and swell the tissue.

The amount of blood in each milliliter of fat aspirate is a key factor, based in liposuction techniques.

A blockage in a lung artery, often caused by a blood clot from a deep vein.

A blood clot in a deep vein, often in the leg. It can be dangerous if the clot travels to the lungs.

Shortness of breath, chest pain, coughing up blood, palpitations, wheezing, and angina-like pain.

Factors associated with an increased likelihood of developing deep vein thrombosis and pulmonary embolism.

Replacement of fluids lost during surgery to maintain blood volume and pressure.

Medical interventions such as anticoagulants (like heparin), thrombolytics, and low-molecular-weight heparin, as well as supportive measures.

A puncture of an internal organ, potentially leading to infection or internal bleeding.

Abnormally low body temperature.

Techniques to maintain a stable body temperature during liposuction surgery.

Keeping the solution used to prepare the skin at a warm temperature.

A device that uses forced air to warm the patient during surgery.

Maintaining a specific temperature in the operating room.

Keeping the injection fluid at 37°C during liposuction.

Obesity increases risk of heart conditions like high cholesterol, high blood pressure, and heart enlargement.

Obesity can cause breathing problems like restrictive lung disease, sleep apnea, and airway issues.

Obesity is linked to conditions like diabetes, gastroesophageal reflux disease, and certain vascular issues.

The anesthesia plan must account for obesity-related conditions to avoid complications during liposuction.

Obesity can impair wound healing, leading to potential complications post-liposuction.