Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Division of Plastic Surgery, Department of Surgery, Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia; ICTEC (Indonesian Clinical Training and Education Center), Cipto Mangunkusumo Hospital/ Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
J Surg Res. 2020 Jan;245:295-301. doi: 10.1016/j.jss.2019.07.066. Epub 2019 Aug 14.
One-per-mil tumescent technique could provide local anesthesia in surgical procedures despite using low lidocaine concentration. Tumescence environment within the tissue may play a role in supporting local anesthesia effect. This study aims to delineate whether the tumescence environment, created by one-per-mil solution without a local anesthetic agent, had a local anesthesia effect.
Four different compositions and volumes of tumescent solutions containing 1:1,000,000 epinephrine were injected into 50 Swiss Webster mice. The animals were divided into five groups: group A, a tumescent solution with 0.2% lidocaine; group B, a tumescent solution with 0.04% lidocaine; group C, a tumescent solution without lidocaine; group D, a doubled volume of tumescent solution without lidocaine; and group E, controls. Local anesthesia effects were tested by using the formalin test (n = 25) and tail immersion test (n = 25). Pain response behavior in the form of paw licking duration and tail withdrawal latency was observed. The analysis of variance and Kruskal-Wallis tests were used to test the statistical difference. Significance was set at P < 0.05.
The four interventional groups showed less pain response behavior and significantly longer tail withdrawal latency (P < 0.05) than the control group. However, the groups showed nonsignificantly shorter paw licking duration than the control (P > 0.05). Group A had the fastest onset of the local anesthesia effect.
The tumescence environment was potentially able to provide a local anesthesia effect, although the solution did not contain a local anesthetic agent as proved by the tail immersion test.
尽管使用的利多卡因浓度较低，百分之一肿胀技术仍可为手术提供局部麻醉。组织内的肿胀环境可能在支持局部麻醉效果方面发挥作用。本研究旨在探讨不含局麻药的百分之一肿胀溶液所产生的肿胀环境是否具有局部麻醉作用。
将含有 1:100 万肾上腺素的四种不同组成和体积的肿胀溶液注入 50 只瑞士 Webster 小鼠。将动物分为五组：A 组，含有 0.2%利多卡因的肿胀溶液；B 组，含有 0.04%利多卡因的肿胀溶液；C 组，不含利多卡因的肿胀溶液；D 组，不含利多卡因的肿胀溶液加倍体积；E 组，对照组。通过福尔马林试验（n=25）和尾浸试验（n=25）测试局部麻醉效果。观察以舔足持续时间和尾巴回缩潜伏期形式出现的疼痛反应行为。使用方差分析和 Kruskal-Wallis 检验来检验统计学差异。显著性水平设为 P<0.05。
四个干预组的疼痛反应行为较少，尾巴回缩潜伏期明显较长（P<0.05），但与对照组相比，舔足持续时间并无显著缩短（P>0.05）。A 组的局部麻醉效果最快出现。
尽管肿胀溶液不含局麻药，但肿胀环境可能具有局部麻醉作用，这一点已通过尾浸试验得到证明。
