Lidocaine Tumescent Solution (Liposuction/Infiltration)
Brand names: Klein's Solution — Compounded; Lidocaine + Adrenaline + Sodium Bicarbonate in Normal Saline
Tumescent lidocaine solution is a dilute local anaesthetic combined with adrenaline (and usually buffered) infiltrated in large volumes into subcutaneous fat to provide anaesthesia and vasoconstriction for liposuction and related infiltration procedures.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
Lidocaine reversibly blocks neuronal voltage-gated sodium channels to prevent nerve conduction, while the added adrenaline causes local vasoconstriction that slows systemic absorption and reduces bleeding.
Prescribing in practice
- Total lidocaine exposure must be carefully calculated and capped to avoid local anaesthetic systemic toxicity, since the large infiltration volumes and delayed absorption can produce late-peaking plasma levels.
- Have a local anaesthetic toxicity protocol and lipid emulsion immediately available wherever tumescent anaesthesia is performed.
- Caution is required with cardiac disease, hepatic impairment, and interacting drugs; prescribe and dilute strictly per current prescribing references and procedural protocols.
Monitoring
Monitor for cardiovascular and CNS signs of local anaesthetic toxicity during and for an extended period after infiltration, given the delayed absorption profile.
Counselling the patient
- Explain that numbing fluid is infiltrated and that the area may stay numb and drain fluid for some time afterwards.
- Advise the patient to report dizziness, perioral tingling, tinnitus, palpitations or confusion immediately.
- Ensure the team records the total local anaesthetic dose administered.
Evidence & guidelines
Tumescent anaesthesia is an established technique; safe maximum lidocaine exposure and resuscitation readiness are emphasised by current prescribing references and local anaesthetic safety guidance.
Reference: Klein JA. J Am Acad Dermatol 1990 (original tumescent paper); AAGBI Intralipid Guidance; ASPS Guidelines on Liposuction Safety; Ostad et al. Dermatol Surg 1996 (pharmacokinetics); Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.