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2008 Annual Meeting Abstracts

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Intraoperative Use of Bupivacaine for Tumescent Liposuction: The Robert Wood Johnson Experience
Colin Failey, M.D., Rahul Vemula, B.S., Gregory L. Borah, M.D., Henry C. Hsia, M.D..
UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

PURPOSE: Bupivacaine is commonly employed as an additive to wetting solution in tumescent liposuction. However, its routine use remains controversial, and there is no known study in the current literature examining the intraoperative use of bupivacaine for tumescent liposuction. The current study reviews the safety and efficacy of bupivacaine for tumescent liposuction procedures performed over a ten-year period at Robert Wood Johnson University Hospital.
METHODS: In accordance with local institutional review board regulations, a retrospective chart review of liposuction procedures performed at Robert Wood Johnson University Hospital in New Brunswick, New Jersey from 1997-2007 was carried out. Procedures were categorized based on the composition of the wetting solution and whether the procedure was done alone or in combination with other procedures. Parameters used to compare groups included patient age, liposuction aspirate volume, length of procedure, length of postoperative stay, and adverse events.
RESULTS: A total of 73 cases were analyzed and categorized into 2 groups based on whether bupivacaine was used as a wetting solution additive. The average age between the two groups was similar (41.5 vs. 42.4 years). The average volume of aspirate removed was not significantly different (1212.5 mL vs. 1598.1 mL; p=0.38). The average procedure time for the bupivacaine group was 126.9 min vs. 140.9 min for the control group (p=0.86). The average recovery time for the bupivacaine group was 188.7 min vs. 189.4 min for the control group (p=0.98). A subset was also analyzed comprising of 19 cases where liposuction was performed in conjunction with abdominoplasty and categorized based on whether bupivacaine was used as a wetting solution additive. The average age between these groups was similar (42.3 vs. 45.1 years). The average volume of aspirate removed was not significantly different (979.6 mL vs. 657.5 mL; p=0.37). The average procedure time for the bupivacaine group was 277.2 min vs. 231.7 min for the control group (p=0.06). A statistically significant difference was found between the groups in the average number of days spent in the hospital post-operatively: 0.9 days for the bupivacaine group vs. 1.6 days for the control group (p=0.01). No significant adverse outcomes were encountered in any group.
CONCLUSION: A review of the experience at Robert Wood Johnson University Hospital shows no evidence to suggest that the intraoperative use of bupivacaine as a wetting solution additive in tumescent liposuction involving relatively low-volume aspirates is any more dangerous than other additives. While there does not appear to be a significant difference in post-operative length of stay for patients who underwent liposuction alone, our data indicate that when performed in conjunction with abdominoplasty, patients who received bupivacaine spent significantly less time in the hospital post-operatively. This evidence suggests that wetting solutions containing bupivacaine may assist in shortening the postoperative length of stay when liposuction is performed in combination with another procedure, but further work must be done to confirm and clarify this finding.


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