The research will involve 50 female participants who have undergone liposuction and will
be divided into two groups.
Group 1: Fluid administration will be determined by the intraoperative fluid ratio. This
ratio is calculated by dividing the sum of subcutaneous infiltration and intravenous
fluid by the total aspirate volume. Depending on the aspiration volume, it will be
maintained at 1-1.4.
Group 2: Participants will be given a fluid maintenance rate of 1.5 ml/kg/h. To determine
fluid responsiveness, the carotid artery peak velocity variation (ΔVPeak-CA) will be
measured before, during, and after the procedure. If the ΔVPeak-CA goes above 15%, the
patient will receive a fluid bolus of lactated ringer solution at a rate of 4-6 ml/kg
over 10-15 minutes, and the team will re-measure fluid responsiveness 10 minutes after
each ΔVPeaK-CA.
During the examination, a single cardiothoracic anesthesiologist will use a 13-6 MHz
linear probe (Fujifilm Sonosite M-Turbo) to measure the peak velocity of the carotid
artery on the left side. The sample volume will be positioned at the center of the lumen,
2 cm from the bulb, and a pulsed wave Doppler examination will be conducted.
To measure the ΔVPeak-CA, the investigators will calculate the maximum and minimum values
during one respiratory cycle. This will be done by using the formula: 100x (maximum peak
velocity - minimum peak velocity) / [(maximum peak velocity + minimum peak velocity)/2].
Surgical technique
The superwet tumescence technique will be the only method utilized for infiltration
during the procedure. All participants will undergo power-assisted liposuction, and a
single surgeon will operate. The wetting solution will contain 1000cc of normal saline
and 2mg of epinephrine in a 1:500,000 ratio. The total Infiltration volume will depend on
the patient.
The total amount of aspiration will depend on the patient and surgery plan and can vary
between 2500 to 5000 ml
During the surgical procedure, the investigators will monitor vital signs such as blood
pressure, heart rate, temperature, oxygen levels, and urine output. Additionally, the
investigators will track the amount of fluids given and removed, and the volume of blood
aspirated.
Following surgery, participants will be hospitalized for 24 hours. During this time, the
investigators will closely monitor the plethysmography variability index (PVI) in both
groups. If the PVI exceeds 15%, participants will receive a ringer lactate fluid bolus of
4-6 ml/kg. Additionally, the investigators will keep track of their urine output, total
fluid intake, and vital signs