The authors present a prospective, randomised, double-blind study to assess whether the inclusion of lignocaine in the standard infiltration for tumescent liposuction, reduces postoperative pain. A cohort of women, aged 18-40, BMI 20-27, and receiving abdominal or back liposuction were randomised to receive lignocaine / adrenaline infiltration to one side and saline / adrenaline to the other. Patient, surgeon and anaesthetist were all blinded to the treatment allocation side. Postoperative pain outcome was measured by visual analogue scale. The results demonstrate a significant reduction in postoperative pain up to 18 hours after surgery; however, the reduction was modest with an average of 0.5 visual analogue scale points. Due to the potentially serious effects of lignocaine toxicity, following the completion of this study, the authors changed their practice and no longer use lignocaine in their standard infiltrate. The advantages of this study are that each patient acts as their own control, taking out the confounding factor of variable pain experience between different patients. The study also looked at postoperative pain scores up to 24 hours after operation. 

Analgesic efficacy of lidocaine for suction-assisted lipectomy with tumescent technique under general anesthesia: a randomized, double-masked, controlled trial.
S Danilla, M Fontbona, V Diaz de Valdes, et al.
PLASTIC AND RECONSTRUCTIVE SURGERY
2013;132:327-32.
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Neil J Cahoon

St John's Hospital, Livingston, UK.

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