Experience with more than 5,000 cases in which monitored anesthesia care was used for liposuction surgery.

BACKGROUND: Conscious sedation using monitored anesthesia care can provide a clinical spectrum from relaxation to moderate anesthesia. This middle ground between general anesthesia and "pure" tumescent liposuction can help facilitate patient comfort and surgical proficiency during the procedure. OBJECTIVE: To describe a method of liposuction surgery with monitored anesthesia care in which a designated licensed and qualified individual is responsible for administration of supplemental intravenous conscious sedation as well as continuous monitoring of the patient. METHODS: Conscious sedation is induced with midazolam, and the patient is titrated to level II-V on the Ramsey sedation scale with propofol. The basic surgical technique is that of tumescent liposuction. However, the supplemental conscious sedation allows the tumescent fluid to be infiltrated at higher rates and fat extraction to be completed in a shorter period with minimal or no discomfort. RESULTS: In the authors' experience with more than 5,000 cases of liposuction surgery using this method, safety and efficacy have been proved. No patients have experienced significant adverse effects. CONCLUSION: Tumescent liposuction surgery with monitored anesthesia care provides a middle ground between general anesthesia and purely tumescent liposuction.