Utilidad de anestesia intravenosa usando un sistema infusión controlada al órgano blanco con anestesia local en aumento mamario submuscular
Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery.
Chung KJ, Cha KH, Lee JH, Kim YH, Kim TG, Kim IG.
Department of Plastic and Reconstructive Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
Arch Plast Surg. 2012 Sep;39(5):540-5. doi: 10.5999/aps.2012.39.5.540. Epub 2012 Sep 12.
Abstract
BACKGROUND: Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. METHODS: This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 µg/mL remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 µg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. RESULTS: Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. CONCLUSIONS: Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.
http://e-aps.org/Synapse/Data/PDFData/2023APS/aps-39-540.pdf
http://e-aps.org/DOIx.php?id=10.5999/aps.2012.39.5.540
Efecto de lidocaína intraoperatoria sobre el consumo anestésico, la función intestinal, el dolor, consumo de analgésicos y estancia hospitalaria después de cirugía mamaria
Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery.
Choi SJ, Kim MH, Jeong HY, Lee JJ.
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2012 May;62(5):429-34. doi: 10.4097/kjae.2012.62.5.429. Epub 2012 May 24.
Abstract
BACKGROUND: Perioperative lidocaine infusion improves postoperative outcomes, mostly after abdominal and urologic surgeries. Knowledge of the effect of lidocaine on peripheral surgeries is limited. Presently, we investigated whether intraoperative lidocaine infusion reduced anesthetic consumption, duration of ileus, pain intensity, analgesic consumption and hospital stay after breast plastic surgeries. METHODS: Sixty female patients, aged 20-60 years, enrolled in this prospective study were randomly and equally divided to two groups. One group (n = 30) received a 1.5 mg/kg bolus of lidocaine approximately 30 min before incision followed by continuous infusion of lidocaine (1.5 mg/kg/h) until skin closure (lidocaine group). The other group (n = 30) was untreated (control group). Balanced inhalation (sevoflurane) anesthesia and multimodal postoperative analgesia were standardized. End tidal sevoflurane concentration during surgery, time to the first flatus and defecation, visual analog pain scale (0-10), analgesic consumption and associated side effects at 24, 48, and 72 h after surgery, hospital stay, and patient's general satisfaction were assessed. RESULTS: Compared to the control group, intraoperative lidocaine infusion reduced by 5% the amount of sevoflurane required at similar bispectral index (P = 0.014). However, there were no significant effects of lidocaine regarding the return of bowel function, postoperative pain intensity, analgesic sparing and side effects at all time points, hospital stay, and level of patient's satisfaction for pain control. CONCLUSIONS: Low dose intraoperative lidocaine infusion offered no beneficial effects on return of bowel function, opioid sparing, pain intensity and hospital stay after various breast plastic surgeries.
KEYWORDS: Analgesic consumption, Anesthetic consumption, Bowel function, Hospital stay, Intravenous lidocaine, Pain score
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366309/pdf/kjae-62-429.pdf
Infiltración para liposucción: La formula Quito. Un nuevo abordaje basado en un concepto antiguo
Liposuction infiltration: The Quito formula - a new approach based on an old concept.
Cueva Galárraga IM.
Plastic Surgery Service, Clínica Club de Leones Quito Central, Quito, Pichincha, Ecuador.
Can J Plast Surg. 2011 Spring;19(1):17-21.
Abstract
INTRODUCTION: Liposuction is a highly sought after surgical procedure. Despite its popularity, not all of the factors associated with its execution are well understood. No well-established guidelines exist for plastic surgeons regarding the subcutaneous infiltration of fluid and, thus, the procedure is often performed subjectively. OBJECTIVE: To establish the usefulness of the Quito formula (infiltrate volume = weight [kg] × percentage of body surface to be liposuctioned × 2.4 [mL]) for calculating the volume of fluid to be infiltrated subcutaneously during small-volume liposuction performed under epidural anesthesia. METHODS: A prospective study was conducted on a group of 50 patients who were candidates for liposuction on multiple body parts between November 2004 and February 2010. RESULTS: The maximum volume of infiltrate was 5000 mL and the maximum volume of aspirate was 4500 mL, with a 30% total aspirated area. No patient required blood transfusion, and there were no major complications. However, one patient presented with a small local infection, another with a sacral seroma and two patients had postdural puncture headaches. No patient showed clinical signs consistent with overhydration, dehydration, pulmonary embolism, fat embolism or lidocaine intoxication. CONCLUSIONS: When performing small-volume liposuction, subcutaneous infiltration using the Quito formula to calculate the volume of infiltrate proved to be useful, safe and objective.
KEYWORDS: Infiltration, Liposuction, Quito formula, Small volume
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086502/pdf/cjps19017.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery.
Chung KJ, Cha KH, Lee JH, Kim YH, Kim TG, Kim IG.
Department of Plastic and Reconstructive Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
Arch Plast Surg. 2012 Sep;39(5):540-5. doi: 10.5999/aps.2012.39.5.540. Epub 2012 Sep 12.
Abstract
BACKGROUND: Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation. METHODS: This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 µg/mL remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 µg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects. RESULTS: Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally. CONCLUSIONS: Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.
http://e-aps.org/Synapse/Data/PDFData/2023APS/aps-39-540.pdf
http://e-aps.org/DOIx.php?id=10.5999/aps.2012.39.5.540
Efecto de lidocaína intraoperatoria sobre el consumo anestésico, la función intestinal, el dolor, consumo de analgésicos y estancia hospitalaria después de cirugía mamaria
Effect of intraoperative lidocaine on anesthetic consumption, and bowel function, pain intensity, analgesic consumption and hospital stay after breast surgery.
Choi SJ, Kim MH, Jeong HY, Lee JJ.
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2012 May;62(5):429-34. doi: 10.4097/kjae.2012.62.5.429. Epub 2012 May 24.
Abstract
BACKGROUND: Perioperative lidocaine infusion improves postoperative outcomes, mostly after abdominal and urologic surgeries. Knowledge of the effect of lidocaine on peripheral surgeries is limited. Presently, we investigated whether intraoperative lidocaine infusion reduced anesthetic consumption, duration of ileus, pain intensity, analgesic consumption and hospital stay after breast plastic surgeries. METHODS: Sixty female patients, aged 20-60 years, enrolled in this prospective study were randomly and equally divided to two groups. One group (n = 30) received a 1.5 mg/kg bolus of lidocaine approximately 30 min before incision followed by continuous infusion of lidocaine (1.5 mg/kg/h) until skin closure (lidocaine group). The other group (n = 30) was untreated (control group). Balanced inhalation (sevoflurane) anesthesia and multimodal postoperative analgesia were standardized. End tidal sevoflurane concentration during surgery, time to the first flatus and defecation, visual analog pain scale (0-10), analgesic consumption and associated side effects at 24, 48, and 72 h after surgery, hospital stay, and patient's general satisfaction were assessed. RESULTS: Compared to the control group, intraoperative lidocaine infusion reduced by 5% the amount of sevoflurane required at similar bispectral index (P = 0.014). However, there were no significant effects of lidocaine regarding the return of bowel function, postoperative pain intensity, analgesic sparing and side effects at all time points, hospital stay, and level of patient's satisfaction for pain control. CONCLUSIONS: Low dose intraoperative lidocaine infusion offered no beneficial effects on return of bowel function, opioid sparing, pain intensity and hospital stay after various breast plastic surgeries.
KEYWORDS: Analgesic consumption, Anesthetic consumption, Bowel function, Hospital stay, Intravenous lidocaine, Pain score
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366309/pdf/kjae-62-429.pdf
Infiltración para liposucción: La formula Quito. Un nuevo abordaje basado en un concepto antiguo
Liposuction infiltration: The Quito formula - a new approach based on an old concept.
Cueva Galárraga IM.
Plastic Surgery Service, Clínica Club de Leones Quito Central, Quito, Pichincha, Ecuador.
Can J Plast Surg. 2011 Spring;19(1):17-21.
Abstract
INTRODUCTION: Liposuction is a highly sought after surgical procedure. Despite its popularity, not all of the factors associated with its execution are well understood. No well-established guidelines exist for plastic surgeons regarding the subcutaneous infiltration of fluid and, thus, the procedure is often performed subjectively. OBJECTIVE: To establish the usefulness of the Quito formula (infiltrate volume = weight [kg] × percentage of body surface to be liposuctioned × 2.4 [mL]) for calculating the volume of fluid to be infiltrated subcutaneously during small-volume liposuction performed under epidural anesthesia. METHODS: A prospective study was conducted on a group of 50 patients who were candidates for liposuction on multiple body parts between November 2004 and February 2010. RESULTS: The maximum volume of infiltrate was 5000 mL and the maximum volume of aspirate was 4500 mL, with a 30% total aspirated area. No patient required blood transfusion, and there were no major complications. However, one patient presented with a small local infection, another with a sacral seroma and two patients had postdural puncture headaches. No patient showed clinical signs consistent with overhydration, dehydration, pulmonary embolism, fat embolism or lidocaine intoxication. CONCLUSIONS: When performing small-volume liposuction, subcutaneous infiltration using the Quito formula to calculate the volume of infiltrate proved to be useful, safe and objective.
KEYWORDS: Infiltration, Liposuction, Quito formula, Small volume
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086502/pdf/cjps19017.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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