Author Affiliation, Ana.
Department of Surgery, Radiology, Anaesthesia and Intensive Care
Tumescent Local Anasthesia and Titrated Sedation; A Safe Technique in Plastic Surgery [Abstract]
West Indian Medical Journal
Date of Publication
Objective: To investigate and report on the consistency of safety in using this technique on a wide range of patients in plastic surgery. Method: Four Hundred and fifty-one patients, 322 female and 129 male, were reviewed between April 1989 and April 2003. All patients were ASA class I or II, and admission was on the day of surgery with overnight stay post-operatively when appropriate. Pre-operative sedation was administered one hour prior to the procedure, as intramuscular injections of pethidine and phenergan. perioperative sedation was administered using titrated doses of midazolam 10-15 mg in 500 mls of 5% dextrose. The operative field was injected subcutaneously with varying volumes of diluted lignocaine (0.1% to 0.25%) and adrenaline (1:200 000 to 1:1 000 000). patients were monitored pre-operatively with continous electro-cardiography blood pressure measurments and pulse oximetry. Conclusion: Diluted tumescent local anaesthesia administration with titrated conscious sedation is a well-tolerated, safe, consistent and effective technique for a variety of plastic surgery procedures. The main benefits are: improved post-operative convalescence, reduced hospital stay, reduction in time off work and reduction in medical care expenses.....