Selkin S G
Division of Otorhinolaryngology, Massapequa General Hospital, Seaford, NY.
Arch Otolaryngol Head Neck Surg. 1989 Jul;115(7):802-3. doi: 10.1001/archotol.1989.01860310040018.
In 500 rhinoplasties, infiltration of 1% lidocaine (Xylocaine) hydrochloride with epinephrine chloride (Adrenalin) 1:100,000 was used in combination with inhalation of halothane (Fluothane) or enflurane (Ethrane). Three arrhythmias requiring treatment occurred when halothane was used. No arrhythmias occurred with the use of enflurane. No complications from anesthesia were observed. No patient had laryngospasm. Bleeding was comparable with that which occurs when infiltration anesthesia is used with intravenous sedation. Enflurane is therefore the inhalation agent of choice for use with 1% lidocaine with epinephrine 1:100,000 for rhinoplasty. Clinical methods and guidelines for safety are set forth with special consideration for the in-office surgical suite.
在500例隆鼻手术中,使用了1%盐酸利多卡因(赛罗卡因)与1:100,000肾上腺素氯化物(肾上腺素)混合液进行浸润麻醉,并联合使用氟烷(氟罗生)或恩氟烷(安氟醚)进行吸入麻醉。使用氟烷时发生了3例需要治疗的心律失常。使用恩氟烷时未发生心律失常。未观察到麻醉相关并发症。无患者发生喉痉挛。出血情况与使用浸润麻醉联合静脉镇静时相当。因此,恩氟烷是与1%利多卡因加1:100,000肾上腺素联合用于隆鼻手术的首选吸入麻醉剂。文中阐述了临床方法及安全指南,并特别考虑了门诊手术套房的情况。