Published in:
01-06-2016 | Original Paper
Systemic exposure to monoethylglycinexylidide in extensive tumescent liposuction
Published in: European Journal of Plastic Surgery | Issue 3/2016
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Background
Plastic surgery patients frequently request extensive liposuction on approximately 30 % of the total body surface area, which indicates that the total dose of lidocaine used might exceed the recommended level. Our previous study demonstrated that the risk of toxicity is low because the peak lidocaine level is below the toxic threshold (3 μg/mL). However, monoethylglycinexylidide (MEGX), the active metabolite of lidocaine, has not been measured in extensive liposuction operations.
Methods
Ten female patients who requested extensive liposuction were enrolled in this study. The targeted areas were divided into two segments and treated in turn for one session. Serum levels of lidocaine and MEGX were taken every 4 h during the first 24 h after the second infiltration.
Results
The peak lidocaine levels (1.94 ± 0.4 μg/mL) were observed after 12–20 h (16.8 ± 2.53 h), whereas the peak MEGX levels (0.67 ± 0.12 μg/mL) were observed after 16–20 h (17.6 ± 2.07 h). The peak concentrations of lidocaine plus MEGX (2.58 ± 0.47 μg/mL) were observed after 17.2 ± 2.4 h.
Conclusions
This study demonstrated that the risk of MEGX toxicity was as low as that of lidocaine toxicity in extensive liposuction operations.
Level of Evidence: Level IV, risk / prognostic study.