腋窝切口胸大肌下假体隆乳术麻醉方法探讨

目的:通过观察不同麻醉方法的止痛效果,探讨腋窝切口胸大肌下假体隆乳术最佳麻醉方法。方法:74例行腋窝切口胸大肌下假体隆乳术的患者,在低剂量间断氯胺酮复合麻醉的基础上,采用不同的局部麻醉方法。其中23例患者行常规局部浸润麻醉,18例行肋间神经阻滞麻醉,33例行胸大肌下局部肿胀麻醉。结果:全部患者均顺利完成手术,术中无因止痛不完善而导致手术终止的情况发生,但是麻醉效果和病人反应各有不同。结论:从安全性和止痛效果来看,低剂量间断氯胺酮复合麻醉 局部浸润麻醉与低剂量间断氯胺酮复合麻醉 胸大肌下局部肿胀麻醉都可以获得较好的麻醉效果。特别是后者同时减少了术中出血和胸大肌的损伤,对于腋窝切口胸大肌下假体隆乳术是最佳的麻醉方法。

Discussion of the anesthesia methods for the augmentation mammoplasty with the prosthesis beneath the pectoral through the incision of axillary

Objective Searching the best method of anesthesia for the augmentation mammoplasty with the prosthesis beneath the pectoral through the incision of maxillary by observing the effect of different methods. Methods All of the 74 patients for the augmentation of mammoplasty with the prosthesis beneath the pectoral through the incision of maxillary were anesthetized with low dosage discontinuous chloracetone general anesthesia and local anesthesia. Among them, 23 cases were performed with routine local anesthesia, 18cases were performed with intercostals nerve block, 33 cases were performed with tumescent local anesthesia. Results All of the patients were performed successfully, with different efficacy of anesthesia and general reactions. Conclusion It is proposed that low dosage discontinuous chloracetone general anesthesia plus routine local anesthesia or tumescent local anesthesia is a good method for the augmentation of mammoplasty. The tumescent local anesthesia reduced the hemorrhage and the muscle wound simultaneously, which is the best way for the augmentation of mammoplasty with the prosthesis beneath the pectoral through the incision of maxillary.