ABSTRACT
As discussed in Chapter 4, many years of experience with the tumescent technique confirm that, with tumescent local anesthesia (TLA) alone, liposuction procedures can be carried out with generally adequate analgesia and relatively high safety. However, precisely this experience leads to such treatment being offered increasingly to older patients with other associated conditions. In addition, the observation of low side-effect and complication rates can lull practitioners into a false sense of security. Lack of experience and practice in emergency situations and lack of emergency equipment can be a safety risk for patients. Individual factors during the liposuction procedure, such as increasing anxiety or pain sensitivity, or the treatment of particularly painful areas, could mean that additional systemic medications may be required for sedation or analgesia. Other factors which can render anesthesiological support desirable are very extensive operations, or known risk factors or underlying conditions in the patient. In the case of extensive procedures, there is an increased risk of side-effects due to the use of larger amounts of TLA which, in turn, increases the need for monitoring and requires the ability to respond rapidly to possible complications.Also, in the case of known underlying conditions with continuous long-term medication, there is
an increased risk of drug interaction or other complications. In the case of excessive risk factors, an elective aesthetic operation should not be performed (see Chapter 9). In cases at increased risk for complications, working with an anesthesiologist may be useful in order to increase the safety margin.
