Böni R
Center for Liposuction, Zürich.
Praxis (Bern 1994). 2007 Jul 4;96(27-28):1079-82. doi: 10.1024/1661-8157.96.27.1079.
Liposuction surgery is increasing in frequency and is the most commonly performed cosmetic procedure to date. Regularly, complications and fatalities are reported by tabloids. The anaesthesiogical techniques used, however, are usually not reported. Tumescent liposuction has to be clearly separated from liposuction with intravenous sedation or under general anaesthesia. In tumescent liposuction, tumescent fluid containing saline, lidocaine and adrenaline is injected into the undesired fat deposits and the pain is controlled locally. In contrast, when liposuctions are performed either with intravenous sedation or under general anaesthesia, the patient is unconscious. In this study, the different anaesthesiological techniques currently used for liposuction were compared with each other. Reported fatalities were reviewed and it was determined, whether liposuction was performed as tumescent liposuction or if systemic sedation was used. To date, no fatalities were reported when tumescent liposuction was performed and a total of 396 457 liposuctions (including own unpublished data) was counted. Fatalities, however, were reported, when either intravenous sedation or general anaesthesia was performed, and a mortality rate of 2.6-19.1 per 100000 cases was counted. Liposuctions should therefore, whenever possible be performed as tumescent liposuction. Intravenous sedation or general anaesthesia should be more carefully considered.
抽脂手术的实施频率日益增加,是迄今为止最常开展的美容手术。小报经常报道抽脂手术的并发症和死亡事件。然而,所采用的麻醉技术通常并未被报道。肿胀麻醉抽脂术必须与静脉镇静或全身麻醉下的抽脂术明确区分开来。在肿胀麻醉抽脂术中,将含有生理盐水、利多卡因和肾上腺素的肿胀液注入不需要的脂肪堆积部位,疼痛通过局部控制。相比之下,当在静脉镇静或全身麻醉下进行抽脂时,患者处于无意识状态。在本研究中,对目前用于抽脂的不同麻醉技术进行了相互比较。对已报道的死亡病例进行了审查,并确定抽脂手术是采用肿胀麻醉抽脂术还是使用了全身镇静。迄今为止,在进行肿胀麻醉抽脂术时未报告死亡病例,总共统计了396457例抽脂手术(包括本人未发表的数据)。然而,在进行静脉镇静或全身麻醉时报告了死亡病例,每10万例的死亡率为2.6 - 19.1。因此,只要有可能,抽脂手术都应采用肿胀麻醉抽脂术。静脉镇静或全身麻醉应更谨慎地考虑。