Tumescent Local Anesthesia

Front Cover
Springer Science & Business Media, 2001 - Medical - 211 pages
It is safe to say that without Jeffrey Klein, who first described tumes cent local anesthesia, this book would never have been written. This technique of local anesthesia, originally designed for use in outpatient liposuction procedures in the United States of America, was intro duced into clinical practice in Darmstadt in 1990 and is now employed in a growing number of areas of surgical dermatology. Eight years of experience have shown it to be a particularly elegant and safe method of local anesthesia, especially in the treatment of large areas of skin. A large number of scientific studies have improved our under standing of tumescent local anesthesia. The administration of large quantities of a dilute local anesthetic into lipophilic tissue is no longer seen as a risk to the patient, although further discussion at the inter national level will be required over the next few years in order to standardize the tumescent solution. Until then, the widely varying dosages reported around the world should be regarded with caution. The progress made and experience gained in recent years make it likely that tumescent local anesthesia will become firmly established in all branches of surgery. One important factor is the economy of the tumescent technique, the material costs of which are very low. In comparison to general anesthesia, enormous savings can be made in the costs of postopera tive care,owing to reduced staff requirements and fewer complications of wound healing.
 

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Contents

Introduction and Definition
3
Historical Background
5
23 Tumescent Anesthesia in Europe
6
Composition of the Solution for Tumescent Anesthesia
9
33 Vasoconstrictors
10
362 Recipes Using Ringers Solution
11
Pharmacology
14
422 Mechanism of Action
16
152 Specific Advantages
104
153 Specific Disadvantages
106
Medial Thigh Lift
107
162 Specific Advantages
108
Tumescent Facelift
109
172 Specific Advantages
112
Skin Flaps
113
182 Specific Advantages
114

423 Absorption Distribution Metabolism and Elimination
18
424 Vasoconstrictor Additives
20
432 Onset of Action
21
434 Infiltration Rate
22
436 Antibacterial Effects
23
437 Antithrombotic Effects
24
Toxicology
28
511 CNS Reactions
29
52 Local Tissue Toxicity
30
54 Methemoglobin Formation
31
55 Local Anesthetic Toxicity in TLA
32
56 Conclusion
33
Sedation and Analgesia
35
61 Perioperative Sedation
38
612 Neuroleptics
39
62 Perioperative Analgesia
40
621 Peripheral Analgesics
41
Prevention of Infection and Thrombosis
44
Advantages and Disadvantages of TLA
47
813 Hydrodissection
48
815 Analgesic Effects
49
82 Specific Disadvantages of TLA
50
824 Patient Management During Surgery
51
Infiltration Technique
55
91 Manual Infiltration
56
92 Mechanical Infiltration
57
93 Temporal Dynamics of Infiltration
60
Technique of Subcutaneous Infusion Anesthesia
61
102 Method
62
1022 Cannulas
63
1025 Infusion Volumes
64
1027 Waiting Period
65
Patient Selection and Preoperative Preparation
68
112 What Preliminary Tests Are Necessary?
69
113 What Safety Precautions Should Be Available?
70
Indications
71
Liposuction
73
121 Technique
81
122 Specific Advantages
83
123 Specific Disadvantages
84
Lipomas
91
131 Technique
92
132 Specific Advantages
95
133 Specific Disadvantages
97
Large Excisions
98
142 Specific Adva ntages
100
Abdominoplasty
102
151 Technique
103
SplitThickness Grafts
117
192 Specific Advantages
118
Dermabrasion
120
202 Specific Advantages
122
Laser Skin Resurfacing
126
212 Technique
127
213 Specific Advantages
128
Axillary Hyperhidrosis
133
222 Specific Advantages
134
223 Specific Disadvantages
135
Acne Inversa
137
231 Technique
138
232 Specific Advantages
139
Hair Transplantation
142
242 Specific Advantages
146
243 Specific Disadvantages
147
Breast Surgery
148
252 Technique
149
253 Specific Advantages
152
Arthroscopy
153
262 Specific Advantages
155
Sentinel Node Biopsy
156
272 Specific Advantages and Disadvantages
158
High Ligation and Stripping of the Long Saphenous Vein
160
282 Specific Advantages
163
283 Specific Disadvantages
165
High Ligation and Stripping of the Small Saphenous Vein
171
292 Specific Advantages
172
293 Specific Disadvantages
173
Phlebectomy
174
301 Technique
176
302 Specific Advantages
178
303 Specific Disadvantages
180
Endoscopic Dissection of Perforator Veins
182
314 Specific Advantages
184
Fasciotomy
186
322 Specific Advantages
187
Debridement of Venous Ulcers
188
322 Specific Advantages
189
Shave Therapy for Crural Ulcers
193
342 Technique
196
343 Specific Advantages
202
Local Anesthesia in Children
204
Toxity of Lidocaine in Correlation to the Plasma Level
209
Possible Toxic side Effects of TLA and their Therapy
210
List of Suppliers
211
Copyright

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