[bwt02]

Anyone use spinals for abdominal liposuction? Surgeon likes to prone the patients too to do the flanks. I know some anesthesia providers do this I just have not and would like to hear your thoughts

[Qwiigley]

Sure, spinal is doable for lipo. I would also tube them, tho. You have an unsecured airway on a prone patient that is most likely on the heavy side.
Depending upon the speed of your surgeon, marcaine should be good. I use it for my c-sec and am pretty happy with it. If they will be in the hospital overnight, you could also add 25mcg of fentanyl to aid in pain relief.
I usually give my patients the choice and our surgeons are happy with whatever we pick.

[stanman1968]

why not?

[INFIDEL]

Originally Posted by stanman1968

why not?

I agree and have seen it done.

I see no reason to tube them also... kind of defeats the purpose of the SAB.

[stanman1968]

Why tube them? Hell if they cannot maintain a patent airway awake then this elective surgery is really quite a risk for them. If they are normal (meaning can maintain an airway) then the risk is greater by screwing with it.

[INFIDEL]

Originally Posted by stanman1968

Why tube them? Hell if they cannot maintain a patent airway awake then this elective surgery is really quite a risk for them. If they are normal (meaning can maintain an airway) then the risk is greater by screwing with it.

It depends on the level of sedation you are going to give with the SAB. As for airway concerns with weight. These people are not NORMALLY morbidly obese so the airway is not USUALLY compromised by redundant tissue and other concerns seen with certain morbidly obese.. It is usually a cosmetic procedure.

My point was EITHER an SAB or a GETA. NOT both.

[stanman1968]

Sorry my writing skills must just suck, but that was sorta my point with SAB no GA, GA no sab