Lai C S, Yip W H, Lin S D, Chou C K, Tseng C K
Division of Plastic and Reconstructive Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical College, Taiwan.
Ann Plast Surg. 1996 Feb;36(2):113-6. doi: 10.1097/00000637-199602000-00001.
Thirty consecutive cases were scheduled for submuscular breast augmentation under continuous thoracic epidural anesthesia. The epidural tube was placed into the intervertebral space between the third and fourth thoracic vertebrae. An average of 15 ml of 2% lidocaine with 1:80,000 epinephrine was used as a primary anesthetic agent. There were no significant changes in respiratory function; only a transient elevation of blood pressure and increased heart rate were noted. All cases were successfully anesthetized, except one case (3%) who had a partial analgesic effect and needed to combine general anesthesia. One patient needed a single dose of ephedrine, 20 mg, to treat hypotension. Perioperative complications included transient shivering (33%), stuffy nose (20%), nausea (7%), and shortness of breath (13%). These symptoms were alleviated after reassurance or light sedation and oxygen inhalation. Immediate postoperative pain of the operative site was effectively controlled by injection of local anesthetics through the epidural tube. This study revealed that thoracic epidural anesthesia was feasible, effective, and even better than conventional alternative anesthetic techniques for breast augmentation.
连续30例患者计划在连续胸段硬膜外麻醉下行胸大肌下隆乳术。硬膜外导管置于第三和第四胸椎之间的椎间隙。平均使用15毫升含1:80,000肾上腺素的2%利多卡因作为主要麻醉剂。呼吸功能无明显变化；仅观察到血压短暂升高和心率加快。除1例（3%）患者有部分镇痛效果且需要联合全身麻醉外，所有病例均成功麻醉。1例患者需要单次注射20毫克麻黄碱来治疗低血压。围手术期并发症包括短暂寒战（33%）、鼻塞（20%）、恶心（7%）和呼吸急促（13%）。经安慰或轻度镇静及吸氧后，这些症状得到缓解。通过硬膜外导管注射局部麻醉剂可有效控制术后手术部位的即时疼痛。本研究表明，胸段硬膜外麻醉对于隆乳术是可行、有效的，甚至优于传统的替代麻醉技术。
