Knize D M, Fishell R
Department of Surgery, University of Colorado Health Sciences Center, Denver, USA.
Plast Reconstr Surg. 1997 Dec;100(7):1867-74. doi: 10.1097/00006534-199712000-00035.
Uniform saturation of subcutaneous fat using the "wetting solution" formula described by Klein for his "tumescent technique" has been shown to decrease operative blood loss associated with liposuction procedures and to eliminate the requirement for general anesthesia for selected patients. However, we found this infusate provided an inadequate level of anesthesia for many of our patients. We use preoperative infusion of Klein's epinephrine and lidocaine containing wetting solution in our lipoplasty practice only for control of blood loss and postoperative pain. Our anesthetic of choice for liposuction is the epidural block technique, which provides consistent intraoperative comfort for the patient. We report our experience with 85 consecutive lipoplasty patients who underwent liposuction under epidural anesthesia after subcutaneous fat perfusion with Klein's wetting solution. Our epidural block technique uses the rapidly metabolized local anesthetic agent, chloroprocaine, which has the lowest systemic toxicity risk of any local anesthetic agent. Chloroprocaine's anesthetic characteristics are particularly well suited for the outpatient surgery patient with few undesirable side effects.
采用克莱因为其“肿胀技术”所描述的“湿润溶液”配方实现皮下脂肪的均匀饱和，已被证明可减少与吸脂手术相关的术中失血，并消除部分患者对全身麻醉的需求。然而，我们发现这种注入液对我们的许多患者而言麻醉程度不足。在我们的脂肪成形手术中，我们仅将术前注入含有克莱因肾上腺素和利多卡因的湿润溶液用于控制失血和术后疼痛。我们进行吸脂手术首选的麻醉方法是硬膜外阻滞技术，它能为患者提供持续的术中舒适感。我们报告了连续85例脂肪成形患者的经验，这些患者在皮下脂肪用克莱因湿润溶液灌注后接受硬膜外麻醉下的吸脂手术。我们的硬膜外阻滞技术使用快速代谢的局部麻醉剂氯普鲁卡因，它是所有局部麻醉剂中全身毒性风险最低的。氯普鲁卡因的麻醉特性特别适合门诊手术患者，几乎没有不良副作用。
