目的:虽然已经描述了许多获取肋软骨的技术,已发表文献中的一个一致性是该手术是在全身麻醉下进行的.这是第一份报告,在涉及肋软骨收获的情况下,提供静脉镇静作为全身吸入麻醉的安全替代方案。
目的:确定静脉镇静下肋软骨收获的可行性和安全性。
方法:对2005年至2019年在静脉镇静下收获肋软骨移植物的116例隆鼻患者进行回顾性分析。
方法:Lasky临床外科中心资深作者(AF)的私人实践。
方法:连续接受美容和/或功能性隆鼻手术的患者。
■涉及气胸的病例数,胸膜损伤的大小,射线照相结果,记录气胸的修复技术和治疗方法。
结果:有7例患者在获取肋软骨时出现胸膜撕裂(大小范围3-8mm),每例均在术中修复。所有7例患者在2L氧气的恢复室中保持临床稳定。虽然临床稳定,一名患者有50%气胸的放射学证据,因此,她被转移到医院放置了海姆利希氏管,并进行了通宵观察。
结论:尽管充分的撕裂可以归因于手术技术而不是麻醉类型,这些病例确实为以下事实提供了宝贵的见解:无需全身麻醉即可成功治疗此类并发症。
OBJECTIVE: While numerous techniques for costal cartilage harvesting have been described, one consistency in the published literature is that the procedure is performed under general anesthesia. This is the first report to offer IV sedation as a safe alternative to general inhalational anesthesia in cases involving costal cartilage harvesting.
OBJECTIVE: To determine the feasibility and safety of costal cartilage harvest with IV sedation.
METHODS: A retrospective chart review was performed of 116 rhinoplasty patients who underwent harvest of costal cartilage grafts under IV sedation from 2005 to 2019.
METHODS: Private practice of senior author (AF) at Lasky Clinical Surgical Center.
METHODS: Consecutive patients who underwent cosmetic and/or functional rhinoplasty.
UNASSIGNED: The number of cases involving a pneumothorax, size of the pleural injury, radiographic findings, repair technique and treatment for pneumothorax were all recorded.
RESULTS: There were 7 cases involving a pleural tear (size range 3-8 mm) during costal cartilage harvest and each of these was repaired intra-operatively. All 7 patients remained clinically stable in recovery room on 2 L of oxygen. Although clinically stable, one patient had radiologic evidence of a pneumothorax of 50%, and thus she was transferred to a hospital for placement of a Heimlich tube with overnight observation.
CONCLUSIONS: Although plenural tears can be attributed to surgical technique rather than the type of anesthesia, these cases do provide valuable insight to the fact that successful management of such complications can be accomplished without the need for general anesthesia.