吸脂术中大剂量使用利多卡因的血药浓度监测及意义

目的 探讨作为局部麻醉剂的利多卡因在肿胀法脂肪抽吸术中的有限剂量是多少，既能达到良好的镇痛效果，又有安全地使用而不产生毒副作用。方法 对１４例大剂量使用低浓度利多卡因作为局麻药的脂肪抽吸术的术中和术后血清利多卡因浓度以免疫荧光测定法进行了动态监测，作出其时间－浓度曲线，并与临床表现相对照。结果 在此类手术中，利多卡因在０．１ｍｇ／ｍｌ的浓度下，加入１／１百万￣１／２百万肾上腺素，其用量可达３５ｍｇ

Monitoring of serum lidocaine concentration in tumescent liposuction infiltrated with high-dosage lidocaine and its clinical significance]

OBJECTIVE: This study was carried out to determine the maximum and safe dosage of lidocaine administered in tumescent liposuction. METHODS: In 14 cases of tumescent liposuction using high-dosage, low-concentration lidocaine as local infiltration anesthetic, serum lidocaine concentrations were monitored with automated fluorescence polarization analysis. RESULTS: The time-concentration curve together with clinical manifestations indicated that in tumescent liposuction, lidocaine, under a concentration of 0.1 mg/ml mixed with 1/1,000,000 to 1/2,000,000 epinephrine, could be administered with a dosage of 35 mg/kg body weight as a local infiltration anesthetic while the serum lidocaine was still within the safety limit and no signs of intoxication manifested. The resulting diminution both in pain and blood loss during the operation enhanced the overall operation safety and suction volume. CONCLUSION: This study provides the basis for high-dosage lidocaine administration in tumescent liposuction.