Seify Hisham
Aesthet Surg J Open Forum. 2022 Jan 27;4:ojab056. doi: 10.1093/asjof/ojab056. eCollection 2022.
Awake plastic surgery performed under minimal sedation has advantages including patient preference, affordability, and easier recovery compared to when performed under deeper sedation. Commonly used oral analgesics may not be adequate for awake procedures resulting in moderate to severe pain. Sufentanil sublingual tablet (SST) 30 mcg has been shown to provide timely analgesia with a safety profile appropriate for minimal-sedation settings.
To examine perioperative outcomes in patients who underwent awake plastic surgery with local anesthesia and SST 30 mcg for pain control.
This study was a prospective single-group cohort study conducted at a single plastic surgery center. SST 30 mcg was administered approximately 30 minutes prior to the procedure. Outcome measures included the number of patients with adverse events, the number of patients requiring medications in the post-anesthesia care unit (PACU), and recovery time.
Among the 31 patients, the most common procedures were liposuction (71%), facelift (10%), and blepharoplasty (6%). The mean (± standard error [SE]) procedural duration was 81 ± 9 minutes. No vital sign instability or oxygen desaturation was observed. Three patients (10%) experienced nausea, only one of which required treatment with oral ondansetron 4 mg in the PACU. One patient (3%) experienced dizziness that did not require treatment. No patients required opioids or other analgesics in the PACU for pain. The mean (±SE) recovery time was 15 ± 4 minutes.
Awake plastic surgery can be performed using SST 30 mcg with minimal side effects and a rapid recovery time.
与在深度镇静下进行的整形手术相比，在最小镇静下进行的清醒整形手术具有诸多优势，包括患者偏好、费用可承受性以及恢复更容易。常用的口服镇痛药可能不足以应对清醒手术所导致的中度至重度疼痛。已证明30微克的舒芬太尼舌下片（SST）能提供及时的镇痛效果，且其安全性适合最小镇静环境。
研究在局部麻醉下接受清醒整形手术并使用30微克SST控制疼痛的患者的围手术期结局。
本研究是在单一整形手术中心进行的前瞻性单组队列研究。在手术前约30分钟给予30微克SST。结局指标包括发生不良事件的患者数量、在麻醉后护理单元（PACU）需要用药的患者数量以及恢复时间。
在31例患者中，最常见的手术是吸脂术（71%）、面部提升术（10%）和眼睑成形术（6%）。平均（±标准误[SE]）手术持续时间为81±9分钟。未观察到生命体征不稳定或氧饱和度下降。3例患者（10%）出现恶心，其中只有1例在PACU需要用4毫克口服昂丹司琼治疗。1例患者（3%）出现头晕，无需治疗。在PACU中没有患者因疼痛需要使用阿片类药物或其他镇痛药。平均（±SE）恢复时间为15±4分钟。
使用30微克SST可进行清醒整形手术，副作用最小且恢复时间快。
