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肿胀局麻用于吸脂小切口腹壁成形术

Tumescent Local Infiltration Anesthesia for Mini Abdominoplasty with Liposuction.

作者信息

Mohamed Ahmed Abdalla, Safan Tamer Fayez, Hamed Hamed Fathy, Elgendy Maged Abdelwahab Abdelaziz

机构信息

Faculty of Medicine, Cairo University, Cairo, Egypt.

Department of Anesthesiology & ICU, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

Open Access Maced J Med Sci. 2018 Nov 19;6(11):2073-2078. doi: 10.3889/oamjms.2018.475. eCollection 2018 Nov 25.

Abstract

AIM

To evaluate the feasibility and safety of mini abdominoplasty with liposuction under local tumescent anaesthesia (LA) as the sole anaesthetic modality.

METHODS

The study included 60 female patients with a mean age of 33.3 ± 5.6 years. Local infiltration using a mixture of 1:1000 epinephrine (1 ml), 2% lidocaine (100 ml) and 0.5% Levobupivacaine (50 ml) in 2500 ml saline was started with Local infiltration started with the abdomen, outer thigh, hips, back, inner thighs and knees. After Mini Abdominoplasty with supplemental liposuction was conducted and application of suction drains wound closure was performed, and the tight bandage was applied. Pain during injection, incision and surgical manipulations was determined. Duration of postoperative analgesia, till oral intake and return home, patients and surgeon satisfaction scores were determined.

RESULTS

All surgeries were conducted completely without conversion to general anaesthesia. Injection pain was mild in 46 patients, moderate in 10 and hardly tolerated in 4 patients. Incision pain was mild in 16 patients, while 44 patients reported no sensation. During the surgical procedure, 6 patients required an additional dose of LA. Meantime till resumption of oral intake was 1.6 ± 0.9 hours. Meantime till home return was 5.6 ± 2.4 hours. Twelve patients were highly satisfied, 18 patients were satisfied, and these 42 patients were willing to repeat the trial if required. Eight patients found the trial is good and only one patient refused to repeat the trial and was dissatisfied, for a mean total satisfaction score of 3.1 ± 0.9.

CONCLUSION

Mini Abdominoplasty with liposuction could be conducted safely under tumescent LA with mostly pain-free intraoperative and PO courses and allowed such surgical procedure to be managed as an office procedure. The applied anaesthetic procedure provided patients' satisfaction with varying degrees in about 97% of studied patients.

摘要

目的

评估以局部肿胀麻醉(LA)作为唯一麻醉方式进行小切口腹部整形术联合抽脂术的可行性和安全性。

方法

该研究纳入60例平均年龄为33.3±5.6岁的女性患者。在2500毫升生理盐水中加入1:1000肾上腺素(1毫升)、2%利多卡因(100毫升)和0.5%左旋布比卡因(50毫升)的混合液进行局部浸润,从腹部、大腿外侧、臀部、背部、大腿内侧和膝盖开始局部浸润。在进行小切口腹部整形术联合抽脂术后,放置引流管并进行伤口缝合,然后施加紧身绷带。测定注射、切口和手术操作过程中的疼痛程度。确定术后镇痛持续时间、直至开始经口进食和出院的时间、患者和外科医生的满意度评分。

结果

所有手术均顺利完成,无需转为全身麻醉。46例患者注射疼痛轻微,10例患者疼痛中度,4例患者难以耐受。16例患者切口疼痛轻微,44例患者无感觉。手术过程中,6例患者需要额外剂量的局部麻醉药。至恢复经口进食的平均时间为1.6±0.9小时。至出院的平均时间为5.6±2.4小时。12例患者非常满意,18例患者满意,这42例患者表示如有需要愿意再次接受该试验。8例患者认为该试验良好,只有1例患者拒绝再次接受试验且不满意,平均总满意度评分为3.1±0.9。

结论

在肿胀麻醉下,小切口腹部整形术联合抽脂术可以安全进行,术中及术后经口进食过程大多无痛,且该手术可作为门诊手术进行管理。所应用的麻醉方法使约97%的研究患者有不同程度的满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af62/6290441/c01f052dc3d2/OAMJMS-6-2073-g001.jpg

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