Experience with more than 5,000 cases in which monitored anesthesia care was used for liposuction surgery.
BACKGROUND
Conscious sedation using monitored anesthesia care can provide a clinical spectrum from relaxation to moderate anesthesia. This middle ground between general anesthesia and "pure" tumescent liposuction can help facilitate patient comfort and surgical proficiency during the procedure.


OBJECTIVE
To describe a method of liposuction surgery with monitored anesthesia care in which a designated licensed and qualified individual is responsible for administration of supplemental intravenous conscious sedation as well as continuous monitoring of the patient.


METHODS
Conscious sedation is induced with midazolam, and the patient is titrated to level II-V on the Ramsey sedation scale with propofol. The basic surgical technique is that of tumescent liposuction. However, the supplemental conscious sedation allows the tumescent fluid to be infiltrated at higher rates and fat extraction to be completed in a shorter period with minimal or no discomfort.


RESULTS
In the authors' experience with more than 5,000 cases of liposuction surgery using this method, safety and efficacy have been proved. No patients have experienced significant adverse effects.


CONCLUSIONS
Tumescent liposuction surgery with monitored anesthesia care provides a middle ground between general anesthesia and purely tumescent liposuction.
Department of Dermatology, Columbia University, College of Physicians and Surgeons, 161 Ft. Washington Avenue, New York, NY 10032, USA.
Dwight A
DA
Scarborough
Joel Bain
JB
Herron
Azim
A
Khan
Emil
E
Bisaccia
D000772:Anesthesia, Local / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D015187:Lipectomy / Q000379:methods; D008874:Midazolam / Q000008:administration & dosage; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D008874:Midazolam