COMPARISON OF 1 MG/L VERSUS 2 MG/L ADRENALINE IN TUMESCENT SOLUTION: HEMODYNAMIC EFFECTS AND CARDIOVASCULAR EVENTS DURING LIPOSUCTION - A RANDOMIZED CONTROLLED TRIAL

Tóm tắt

 Objectives: To compare the hemodynamic changes and cardiovascular adverse events associated with two adrenaline concentrations (1 mg/L vs. 2 mg/L) in tumescent solution for patients undergoing liposuction under general anesthesia. Methods: A randomized clinical trial was conducted at Le Huu Trac National Burn Hospital (Hanoi, Vietnam) from January to August 2025. 132 ASA I - II patients undergoing elective liposuction were randomly assigned to receive tumescent solution containing either 1 mg/L (group 1, n = 66) or 2 mg/L (group 2, n = 66) adrenaline with lidocaine. Primary outcomes were changes in heart rate (HR) and mean arterial pressure (MAP) recorded at baseline, 30, 60, 90 minutes, and procedure end. Secondary outcomes included the incidence of tachycardia, hypertension, and surgeon satisfaction scores. Results: Baseline characteristics were comparable between groups. Group 2 demonstrated significantly higher HR and MAP at all post-infiltration timepoints compared to group 1 (p < 0.05). Tachycardia incidence was markedly higher in group 2 than in group 1 (31.82% vs 10.61%, p < 0.05), consistent with a higher rate of hypertension (22.73% vs 6.06%, p < 0.05). Despite pronounced hemodynamic differences, surgeon satisfaction scores remained comparable between groups (p > 0.05). Conclusion: Increasing adrenaline concentration from 1 mg/L to 2 mg/L in tumescent solution is associated with a significantly higher risk of cardiovascular instability without improving surgical outcomes. These findings support the use of 1 mg/L adrenaline as the optimal concentration for tumescent anesthesia in liposuction under general anesthesia.