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肿胀局麻下安全有效的隆乳上提术:十年经验

Safe and Effective Augmentation Mastopexy with Tumescent Local Anesthesia: A Decade of Experience.

作者信息

Ziani Federico, Tettamanzi Matilde, Arrica Giovanni, Cuomo Roberto, Filigheddu Edoardo, Trignano Claudia, Liperi Corrado, Rubino Corrado, Trignano Emilio

机构信息

Plastic Surgery Unit, University Hospital Trust of Sassari, 07100 Sassari, Italy.

Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.

出版信息

J Clin Med. 2024 Oct 11;13(20):6057. doi: 10.3390/jcm13206057.

Abstract

: Tumescent local anesthesia (TLA) is widely used in esthetic surgery due to its ability to reduce complications, eliminate the need for general anesthesia, provide effective pain control, and shorten hospitalization times. : This study evaluates the use of TLA in 80 patients who underwent augmentation mastopexy between 2010 and 2022. A tumescent solution containing 500 mg lidocaine, 672 mg sodium bicarbonate, and 1 mg epinephrine in 1000 mL of saline was infiltrated, with an average of 300 mL per breast. The surgical technique involved creating a subpectoral pocket for textured round implants (250-400 cc), followed by careful hemostasis. : No patients required conversion to general anesthesia, and there were no signs of toxicity or major complications. Minor complications included wound dehiscence (6.2%), hematoma (2.5%), and capsular contracture (2.5%). Pain management satisfaction at 3 months post-surgery was rated as "outstanding" by 12.5% of patients, "excellent" by 67.5%, and "good" by 20%. The longest follow-up was 6 years, with no implant ruptures except one (1.2%). : While the study did not include a control group or statistical analysis, the findings suggest that TLA is a safe and effective alternative to general anesthesia for augmentation mastopexy, providing excellent pain control and a low rate of complications.

摘要

肿胀局麻(TLA)因其能减少并发症、无需全身麻醉、提供有效的疼痛控制并缩短住院时间,而被广泛应用于美容手术。本研究评估了2010年至2022年间接受隆乳上提术的80例患者中TLA的使用情况。将含有500毫克利多卡因、672毫克碳酸氢钠和1毫克肾上腺素的肿胀液注入1000毫升生理盐水中,每侧乳房平均注入300毫升。手术技术包括为毛面圆形乳房植入物(250 - 400立方厘米)创建胸肌下腔隙,随后仔细止血。没有患者需要转为全身麻醉,也没有毒性或重大并发症的迹象。轻微并发症包括伤口裂开(6.2%)、血肿(2.5%)和包膜挛缩(2.5%)。术后3个月疼痛管理满意度方面,12.5%的患者评为“出色”,67.5%评为“优秀”,20%评为“良好”。最长随访时间为6年,除一例(1.2%)外无植入物破裂情况。虽然该研究未设对照组或进行统计分析,但研究结果表明,对于隆乳上提术,TLA是全身麻醉的一种安全有效的替代方法,能提供出色的疼痛控制且并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39b8/11509041/837a68b5fc5b/jcm-13-06057-g001.jpg

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