ELIZA

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288686 occurrences (No.85 in the rank) during 5 years in the PubMed. [no cache] 500 found

269) It has a high margin of safety, without increasing of lidocaine toxicity or adverse cardiopulmonary sequelae while using a segmental tumescent infiltration with lower concentration of lidocaine.

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PMID:24051464 DOI:10.1097/SAP.0b013e3182933de7

2015 Annals of plastic surgery

* Safe extensive tumescent liposuction with segmental infiltration of lower concentration lidocaine under monitored anesthesia care.

- Tumescent anesthesia makes it feasible to perform liposuction in an office setting. There are often patients who desire extensive liposuction on approximately 30% of total body surface area, which means the lidocaine total dose might be over the dosing recommendation. So the segmental infiltration is applied, although the concentration of lidocaine in tumescent fluid is gradually reduced to 0.0252%. Moreover, supplemental intravenous (IV) sedation using monitored anesthesia care is usually applied concurrently to help alleviate discomfort and pain of the patients during tumescent anesthetic infusion and fat extraction which in turn increases the risks of potential lidocaine toxicity due to possible drug interactions. This study was to demonstrate the safety of segmental infiltration of tumescent fluid with lower lidocaine concentration combined with IV sedation in extensive liposuction and determine whether the risk of lidocaine toxicity is increased in this protocol. Ten female patients who requested the extensive liposuction participated in the study. The targeted areas were divided into 2 segments and treated in turn in 1 session. Lidocaine (1600 mg) was infiltrated into the first segment, and approximately 928 mg lidocaine was subsequently infiltrated after accomplishment of the first segment operation. Serum levels of lidocaine were taken every 4 hours during the first 24 hours after the second infiltration. The average time of the procedure is 222 (33) minutes. The dose and total amount of lidocaine injected are 40.7 (5.8) mg/kg and 2528.2 (155.2) mg, respectively. The total volume of the infusates and aspirates are 9918.1 (494) and 6325 (1461.6) mL, respectively, the ratio of total infusates to total aspirates is 1.66 (0.45). The total aspirated fat and fluids are 3280 (1051.8) and 3045 (824.1) mL, respectively. The peak lidocaine levels [2.18 (0.63) μg/mL] occurred after 12 to 20 hours [16.4 (2.27) hours]. No significant correlation between dose per kilogram body weight or total dose of lidocaine infiltrated and its peak levels or time existed. The extensive liposuction covering the 30% total body surface areas was well tolerated by the patients under tumescent anesthesia in combination with the supplemental IV sedation. Our previous study on the fluid management has demonstrated the risk of hypovolemia or fluid overload is very low with this technique, although the patients who received only maintenance fluid (500 mL) in the operating room and could discharge and resume oral intake after 6 hours of recovery room stay. The adequate anesthesia support is available in our office-based setting with adequate recovery facilities in place. It has a high margin of safety, without increasing of lidocaine toxicity or adverse cardiopulmonary sequelae while using a segmental tumescent infiltration with lower concentration of lidocaine.

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(1)38 than	(19)4 incidence	(37)3 socioeconomic	(55)2 expression
(2)35 in	(20)4 leg	(38)3 stresses	(56)2 eyelid
(3)19 levels	(21)4 spine	(39)3 values	(57)2 eyelids
(4)12 extremity	(22)4 total	(40)2 Condom	(58)2 frequencies
(5)11 risk	(23)3 (P	(41)2 EI	(59)2 frequency
(6)7 compared	(24)3 null	(42)2 IQ	(60)2 likelihood
(7)7 level	(25)3 ASM/wt	(43)2 abdominal	(61)2 limit
(8)7 limb	(26)3 education	(44)2 among	(62)2 microleakage
(9)5 at	(27)3 educational	(45)2 back	(63)2 perceived
(10)5 for	(28)3 extremities,	(46)2 birthweight	(64)2 percentage
(11)5 limbs	(29)3 heart	(47)2 bounds	(65)2 quality
(12)5 the	(30)3 initial	(48)2 by	(66)2 rate
(13)4 and	(31)3 legs	(49)2 complication	(67)2 resilience
(14)4 body	(32)3 mean	(50)2 concentration	(68)2 serum
(15)4 cervical	(33)3 odds	(51)2 concentrations	(69)2 shear
(16)4 dose	(34)3 prevalence	(52)2 demineralization
(17)4 doses	(35)3 probability	(53)2 esophageal
(18)4 extremities	(36)3 sexual	(54)2 estimated

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--- WordNet output for lower --- =>1.低くする/なる, 下げる/下がる, 卑しめる, 2.しかめっ面, 3.lowの比較級 Overview of noun lower The noun lower has 1 sense (no senses from tagged texts) 1. lower berth, lower -- (the lower of two berths) Overview of verb lower The verb lower has 5 senses (first 3 from tagged texts) 1. (15) lower, take down, let down, get down, bring down -- (move something or somebody to a lower position; "take down the vase from the shelf") 2. (6) lower, lour -- (set lower; "lower a rating"; "lower expectations") 3. (1) turn down, lower, lour -- (make lower or quieter; "turn down the volume of a radio") 4. lower, depress -- (cause to drop or sink; "The lack of rain had depressed the water level in the reservoir") 5. frown, glower, lour, lower -- (look angry or sullen, wrinkle one's forehead, as if to signal disapproval) Overview of adj low The adj low has 10 senses (first 6 from tagged texts) 1. (55) low -- (less than normal in degree or intensity or amount; "low prices"; "the reservoir is low") 2. (23) low -- (literal meanings; being at or having a relatively small elevation or upward extension; "low ceilings"; "low clouds"; "low hills"; "the sun is low"; "low furniture"; "a low bow") 3. (11) low, low-toned -- (very low in volume; "a low murmur"; "the low-toned murmur of the surf") 4. (6) low -- (unrefined in character; "low comedy") 5. (4) low, low-pitched -- (used of sounds and voices; low in pitch or frequency) 6. (3) abject, low, low-down, miserable, scummy, scurvy -- (of the most contemptible kind; "abject cowardice"; "a low stunt to pull"; "a low-down sneak"; "his miserable treatment of his family"; "You miserable skunk!"; "a scummy rabble"; "a scurvy trick") 7. humble, low, lowly, modest, small -- (low or inferior in station or quality; "a humble cottage"; "a lowly parish priest"; "a modest man of the people"; "small beginnings") 8. depleted, low -- (no longer sufficient; "supplies are low"; "our funds are depleted") 9. broken, crushed, humbled, humiliated, low -- (subdued or brought low in condition or status; "brought low"; "a broken man"; "his broken spirit") 10. gloomy, grim, blue, depressed, dispirited, down, downcast, downhearted, down in the mouth, low, low-spirited -- (filled with melancholy and despondency ; "gloomy at the thought of what he had to face"; "gloomy predictions"; "a gloomy silence"; "took a grim view of the economy"; "the darkening mood"; "lonely and blue in a strange city"; "depressed by the loss of his job"; "a dispirited and resigned expression on her face"; "downcast after his defeat"; "feeling discouraged and downhearted") --- WordNet end ---