局麻或加静脉强化麻醉下乳腺癌切除术

目的分析局部麻醉或加静脉强化麻醉下进行乳腺癌手术的临床效果。方法7例女性乳腺癌患者,因为不同原因不便或不愿意进行气管内插管全身麻醉,使用局部麻醉(利多卡因)或加静脉强化麻醉(氟芬合剂)实施乳房局部手术+乳腔镜腋窝淋巴结清扫手术。结果所有患者对术中麻醉效果满意。术后切口均1期良好愈合,未出现皮下积液、积血和皮瓣坏死等并发症。全组病例术后随访6~59个月,术后患者短期恢复佳,无1例因手术麻醉致循环呼吸衰竭而死亡。随访期间未发现乳腺癌在乳房和腋窝局部复发。结论局部浸润麻醉或配合静脉强化麻醉对某些特殊患者方便、可行,提高了外科手术的安全性,患者术后恢复好,为以后开展乳腺癌当日手术(day operation)提供了经验。

The Experiences of Breast Cancer Operation under Local Anesthesia or(and) Intravenous Intensified Anesthesia

Objective To analysis the local anaesthesia or/and intravenous intensified anaesthesia. Methods Local breast surgery and mastoscopic axillary lymph node dissection were performed under local anaesthesia or/and intravenous intensified anaesthesia in 7 cases of breast cancer. Results All patients were satisfied with the whole anaesthesia process during operations. The incisions healed well. There was no subcutaneous liquid accumulation, blood accumulation, skin-flap necrosis and other complications. Follow-up period was 6～59 months. Patients recovered well after operation. No case died from circulatory and respiratory failures caused by the attacks of operation and anaesthesia. Local recurrences of cancer in breast or axilla were not observed during follow-up period. Conclusion Local anaesthesia or/and intravenous intensified anaesthesia is one of the good options for some special patients. It is convenient and feasible. It improves the safety of surgery. Patients, recovery becomes simple after operation. It provides the experience for performing "day operation" in breast cancer in the days to come.