Deaths related to liposuction.
Deaths related to liposuction.
复制标题
与吸脂术有关的死亡。
DOI：
10.1056/nejm199905133401904
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
R. Hoffman
中科院分区：
文献类型：
--
作者：
R. Rao;Susan F. Ely;R. Hoffman
背景
肿胀吸脂技术包括皮下注射含有利多卡因的溶液，然后通过微套管抽吸脂肪。虽然利多卡因的推荐剂量高达每公斤体重55毫克，但几乎没有安全性数据。由于报告肿胀吸脂术相关不良事件不是强制性的，因此并发症和死亡的发生率未知。
方法
在1993年至1998年间提交给纽约市首席医学检查官办公室的48,527例死亡病例中，我们确定了5例肿胀吸脂后死亡。回顾病人的病历和验尸结果，以确定共同的促成因素。
结果
这5名患者接受的利多卡因剂量范围为每公斤10至40毫克。还给予其他药物，如咪达唑仑。3例患者因术中突然低血压和心动过缓死亡，原因不明。两名患者的死后血液利多卡因浓度分别为5.2和2 mg/L。1例患者死于液体超负荷，1例患者在腿部肿胀吸脂后死于小腿深静脉血栓形成伴肺血栓栓塞。
结论
肿胀吸脂术可能是致命的，部分原因可能是利多卡因毒性或利多卡因相关的药物相互作用。
BACKGROUND
The technique of tumescent liposuction involves the subcutaneous infusion of a solution containing lidocaine, followed by the aspiration of fat through microcannulas. Although the recommended doses of lidocaine are as high as 55 mg per kilogram of body weight, few safety data are available. Since reporting of adverse events associated with tumescent liposuction is not mandatory, the incidence of complications and deaths is unknown.
METHODS
We identified 5 deaths after tumescent liposuction among 48,527 deaths referred to the Office of Chief Medical Examiner of New York City between 1993 and 1998. The patients' records and postmortem examination results were reviewed to identify common contributory factors.
RESULTS
The five patients had received lidocaine in doses ranging from 10 to 40 mg per kilogram. Other drugs, such as midazolam, were also administered. Three patients died as a result of precipitous intraoperative hypotension and bradycardia with no definitively identified cause. Postmortem blood lidocaine concentrations in two of the patients were 5.2 and 2 mg per liter. One patient died of fluid overload, and one died of deep venous thrombosis of calf veins with pulmonary thromboembolism after tumescent liposuction of the legs.
CONCLUSIONS
Tumescent liposuction can be fatal, perhaps in part because of lidocaine toxicity or lidocaine-related drug interactions.