In the procedure of liposuction under local anesthesia, drug toxicity is the most fearful complication and the factor that limits the use of this form of anesthesia. Recently developed liposuction under regional local anesthesia by tumescent technique uses large volumes of a dilute anesthetic solution to produce swelling and firmness of targeted areas.
  From empirical basis, many clinicians found taht does of lidocaine which was quite larger than safe does in conventional local injection could be used in tumescent technique without untoward reaction. 
  The main reason for this is the slow absorption from the subcutaneous tissue resulting in delayed peak level of lidocaine, Several factors, such as lipid-soluble property of lidocaine, dilution of the local anesthetic and the addition of epinephrine, may explain this slow absorption.
  There are several reports for maximal safe dose of lidocaine during tumescent technique in foreign literature, but there is no report in Korea.
This study evaluated the use of large volumes of subcutaneously infiltrated lidocaine as the local anesthetic procedure of tumescent techique(lidocaine lgm + epinephrine 1mg + sodium bicarbonate 12.5 mEq in N/S 1L) in 3 patients underwent suction assisted lipectomy and the results suggested that maximal safe does for lidocaine using the tumescent technique was estimated to be larger than recommended dose.
  The results obtained were as follows:
 1. The peak plasma level of lidocaine varied between 0.50 and 1.11㎍/ml and occurred between 3 and 9 hours after beginning the infiltration. And no other symptoms or signs that could be consistent with lidocaine toxicity were in any of patients.
 2. We injected lidocaine subcutaneously up to 2.4 times (17mg/kg) the maximal recommended dose (7mg/kg) without reaching toxic levels(5㎍/ml) in any of our patients.
 3. A maximal safe dosage for lidocaine using the tumescent technique was estimated to be larger than 17mg/kg