A Combined Prilocaine-Lidocaine Tumescent Solution Has Lower Clinical Side Effects Compared With Lidocaine Only

Abstract

In awake liposuction surgery, the extent of surgery that can be performed in a single session is limited to the toxic threshold levels of the anesthetic. Today, lidocaine is the most commonly used anesthetic. The purpose of this study was to evaluate the clinical safety of a combined prilocaine-lidocaine tumescent solution, and to compare its efficacy and safety to patients receiving lidocaine only. In this cross-sectional study, the efficacy and the occurrence of clinical side effects of a prilocaine-lidocaine tumescent solution were compared with a standard solution containing lidocaine only. All patients received the same dose of prilocaine-lidocaine (n = 142) and of lidocaine (n = 142), respectively. Both tumescent solutions provided similar and effective local anesthesia during lipoaspiration. There were significantly more early signs of toxicity (nausea, irritation, light-headedness, and tachycardia) in patients receiving the standard lidocaine solution. A tumescent solution containing both lidocaine and prilocaine reduces the occurrence of early signs of toxicity of 1 or both anesthetics. It is a safe solution, provided the surgeon has extensive knowledge of potential adverse effects, and the guidelines of care for liposuction are strictly followed.