**9. Postoperative analgesia and hyperbaric oxygen therapy**

Postoperative analgesics are extraordinarily mandatory in the professional management and prevention of acute and chronic pain after liposuction. It is usually started from the beginning of the surgery with an infusion with 300 mg of ketorolac, 300 mg of tramadol in 100 mL/2 mL/h, considered as basal analgesic scheme. It is also valid to resort if necessary to some rescue strategies, in which the analgesic and anti-inflammatory effect of hyperbaric oxygenation therapy can be considered. This therapy is routinely provided to all of our patients in the next 4 to 5 days after their procedure [41, 42].

The use of hyperbaric oxygenation therapy (**Figure 9**) has also reduced the need for pharmacological thromboprophylaxis, since it has been shown that hyperbaric oxygen by the action of nitric oxide decreases the expression of intracellular adhesion molecules (ICAM-1),

**Author details**

México

México

**References**

10.024

Sergio Granados-Tinajero1

Marcela Contreras-López3

\*, Carlos Buenrostro-Vásquez1

1 Clínica Buenrostro de Cirugía Plástica y Medicina Hiperbárica, Tijuana, Baja California,

3 Anesthesia Department, Hospital General de Tijuana, ISESALUD, Tijuana, Baja California,

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\*Address all correspondence to: granadosts@gmail.com

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and

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**Figure 9.** Partial view of the Hyperbaric Center at Buenrostro Clinic of Plastic Surgery and Hyperbaric Medicine in Tijuana México.

a factor that participates in favoring thrombus formation [43]. In addition, another of the already proven actions of hyperbaric oxygen that contribute to diminish the possibility of venous thrombosis formation is its capacity to favor the expression of fibrinolytic factors [44]. In this way in the last 8 years, with an average of 200 liposuctions performed per year, we have only resorted to the use of low-molecular-weight heparin in 2 patients, one of them had a history of deep vein thrombosis 3 years before liposuction, and the other patient was an exceptional case, since for traumatic reasons the patient was paraplegic for 5 years before her surgery.
