两步法肿胀麻醉术在经腋窝胸大肌后假体隆乳术中的应用

目的：回顾性研究两步肿胀麻醉方法在经腋窝胸大肌后隆乳术中的应用效果．方法：肿胀麻醉方法分两步完成．第一步：切口及胸大肌后方路径肿胀麻醉，切开皮肤，皮下组织，分离到达胸大肌后间隙．第二步，用手指导引长钝头注射针进入胸大肌后间隙，将肿胀麻醉液直接注射到胸大肌在内、下、外侧的起始点，实现拟剥离腔隙周边直接浸润注射麻醉．结果：47例患者两步肿胀麻醉方法下完成了经腋窝胸大肌后的隆乳术，麻醉效果满意，不需要辅助静脉镇痛，手术过程无痛，无麻醉相关的并发症．结论：两步肿胀麻醉法简单，安全．可以为经腋窝胸大肌下隆乳手术提供良好的麻醉．

Experience with two-stage tumescent technique on transaxillar subpectoral augmentation mammoplasty

Objective The study goal was to retrospectively review the effectiveness of a two-stage tumescent technique to provide anesthesia for transaxillar subpectoral augmentation. Methods The tumescent anesthesia was carried on two stages. First stage the tumescent fluid was injected in operative location. Incision, dissection was carried out, and the gap of post pectoralis major was exposed. Second stage, a long, blunt tip injection needle was introduced into the gap, tumescent liquid was directly injected into the medial, lower and lateral site pectoralias major originates, that offered adequate anesthesia for preparing the socket and inserting of the implant. Results All patients were treated with a two-stage tumescent technique without intravenous sedation. All patients tolerated the procedure comfortably without intravenous sedation/analgesia. Conclusion The two-stage tumescent technique is a safety, valuable method to provide patient comfort during transaxillar subpectoral augmentation mammoplasty.