TUMESENT LOCAL ANESTESIA WITH ANALGOSEDATION (REMIFENTANIL, DEXMEDETOMIDINE) IN LIPOSUCTION AND LIPOSCULPTURING

Abstract

Tumescent local anesthesia has revolutionized the field of liposuction and body contouring by enabling large-volume fat removal with minimal blood loss and enhanced patient safety. This technique involves the subcutaneous infiltration of a dilute solution of local anesthetic (commonly lidocaine) and epinephrine, producing profound regional anesthesia, vasoconstriction, and tumescence of the targeted tissue. When combined with analgosedation, particularly with short-acting agents such as remifentanil and dexmedetomidine, it offers a balanced approach between patient comfort and procedural control.

Remifentanil, an ultra–short-acting opioid, provides potent analgesia with rapid onset and offset, allowing precise titration to surgical needs and a smooth recovery profile. Dexmedetomidine, a selective α2-adrenergic agonist, provides anxiolysis, sedation, and analgesic-sparing effects while maintaining respiratory stability—a key advantage in procedures performed under local anesthesia. The synergistic combination of these agents minimizes intraoperative discomfort, reduces the need for higher doses of lidocaine, and improves overall patient tolerance.

This review summarizes current evidence and clinical experience supporting the use of tumescent local anesthesia with remifentanil–dexmedetomidine sedation in liposuction and liposculpture. The approach enhances patient satisfaction, optimizes perioperative hemodynamics, and ensures faster recovery with a low incidence of complications, making it an increasingly preferred modality in modern aesthetic surgery.