Gumucio C A, Bennie J B, Fernando B, Young V L, Roa N, Kraemer B A
Division of Plastic Surgery, Washington University School of Medicine, St. Louis, MO.
Plast Reconstr Surg. 1989 Oct;84(4):624-7.
Many plastic surgical procedures are dependent on or aided by the use of local anesthetics. Drug toxicity, although uncommon, is the most feared complication of this technique. There are multiple factors that lead to varying drug levels. These include drug concentration, speed of injection, rate of degradation, total dosage, site of injection or application, rate of administration, and the adjunctive use of vasoconstrictors. This study evaluates the use of subcutaneously injected lidocaine in patients undergoing suction-assisted lipectomy and augmentation mammaplasty. Lidocaine in the concentration of 0.5% containing either 1:100,000 or 1:200,000 epinephrine was used in doses up to 500 mg. Serial lidocaine levels were then obtained up to 1 1/2 hours after injection utilizing two different assay techniques. Our findings demonstrate consistently nondectable serum lidocaine levels despite the use of doses in excess of recommended "safe" amounts. This suggests that under specific circumstances and with certain operative procedures, lidocaine dosing can be liberalized.
许多整形外科手术依赖于局部麻醉剂的使用或借助其辅助。药物毒性虽然不常见，但却是该技术最令人担忧的并发症。有多种因素会导致药物水平的变化。这些因素包括药物浓度、注射速度、降解速率、总剂量、注射或应用部位、给药速率以及血管收缩剂的辅助使用。本研究评估了皮下注射利多卡因在接受吸脂术和隆乳术患者中的应用。使用了浓度为0.5%、含1:100,000或1:200,000肾上腺素的利多卡因，剂量高达500毫克。然后在注射后长达1.5小时内，利用两种不同的检测技术获取系列利多卡因水平。我们的研究结果表明，尽管使用的剂量超过了推荐的“安全”量，但血清利多卡因水平始终无法检测到。这表明在特定情况下和某些手术操作中，利多卡因的给药剂量可以放宽。
