Insights
How “numb” actually works
Tumescent anesthesia is a small piece of clever physiology: swell the tissue, numb the nerves, shrink the blood vessels.
Pain & comfort · 2 min read
Tumescent anesthesia floods the treatment area with a large volume of very dilute lidocaine and epinephrine. Three things happen at once: the nerves in that tissue are numbed, the epinephrine narrows blood vessels, and the fluid itself separates the tissue layers.
In a 1993 report on large-volume liposuction, Dr. Jeffrey Klein described the technique as virtually eliminating surgical blood loss and completely eliminating the risks of general anesthesia in that setting. In 112 patients the mean amount of whole blood suctioned was about 18.5 mL, and the last 87 patients received no parenteral sedation.
The honest part: numb does not mean you feel nothing. Pressure, tugging and vibration travel along different nerve fibres from sharp pain, so you may still notice them. The lidocaine dose also has a ceiling, which is why a physician watches the total dose and your vital signs.
The awakeMD angle: an anesthesiologist tracks the dose, the monitors and your comfort, so the surgeon can focus on the surgery.
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References
- Klein JA. Tumescent technique for local anesthesia improves safety in large-volume liposuction. Plast Reconstr Surg. 1993;1085-1098. PMID 8234507