Investigating the necessary volume of intravenous fluids in tumescent liposuction

Abstract Background: There is no general agreement on appropriate fluid resuscitation in patients undergoing liposuction. Objective: To determine the volume of intravenous fluid replacements in tumescent liposuction. Methods: This was a clinical trial in which 50 healthy patients undergoing liposuction by tumescent technique at Imam Musa Kazem Hospital. in Isfahan (Iran) were investigated during the period between 2001and 2006. The guidelines used for fluid resuscitation were the “4, 2, 1 rule” for group 1 with volume aspiration ≤ 4 liters, and “4, 2, 1 rule” plus 0.25 ml iv crystalloid per cc of aspirate larger than 4 liters for group 2 with volume aspiration > 4 liters. All patients were fully monitored for arterial blood pressure, pulse rates, respiratory rates, and Sa O2. Later, the data were statistically analyzed by SPSS using t-student and 2 tests. Findings: Mean absolute value of pulse rates 6 hours postoperatively were significantly lower than those obtained preoperatively. The mean absolute value of Sa O2 during operation was significantly higher than that of preoperation period. The mean variations of respiratory rates in patients who underwent volume aspiration ≤ 4 liters during and after operation were significantly higher than those with aspiratory volume > 4 liters. Conclusion: Tumescent liposuction surgery using large volumes of subcutaneous infusion could be regarded as a safe and effective technique if the fluid replacement, bleeding, perioperative complications, and postoperative infection are properly controlled.