Relationship between Postoperative Complications and Ratio of Amount of Wetting Solution to Ideal Body Weight in Liposuction Procedures

The use of wetting solutions (WSs) during high-volume liposuction is standard; however, the optimal amount of WS and its components and their effect on postoperative complications are unclear. We evaluated the effect of a WS and its components, calculated according to ideal body weight (IBW), on postoperative complications. High-volume liposuction with a WS containing 0.5 g of lidocaine and 0.5 mg of epinephrine in each liter was performed in 192 patients. Patients who received ≤90 mL/kg of WS were designated as group I and those who received >90 mL/kg of WS as group II. Postoperative complications and adverse events that occurred until discharge were recorded. The mean total amount of epinephrine in the WS was significantly higher for group II (3.5 mg; range, 3.0-4.0 mg) than for group I (2.0 mg; range, 1.8-2.5 mg; < 0.001), as was the mean total amount of lidocaine (3.5 g [range, 3.5-4.3 g] vs. 2.0 g [range, 1.8-2.5 g], respectively; < 0.001). No major cardiac or pulmonary complications occurred in either group. Administration of >90 mL/kg of WS increased the median risk of postoperative nausea 5.3-fold (range, 1.8- to 15.6-fold), that of hypertension 4.9-fold (range, 1.1- to 17.7-fold), and that of hypothermia 4.2-fold (range, 1.1- to 18.5-fold). The two groups had similar postoperative pain scores and blood transfusion rates. The risks of postoperative nausea, vomiting, hypothermia, and hypertension may increase in patients who receive >90 mL/kg of WS calculated according to IBW during high-volume liposuction.