背景:舒适和康复是寻求美容手术的患者的主要关注点。这项研究旨在评估镇静下门诊乳腺手术后的疼痛和恢复情况,肋间阻滞,和局部麻醉。
方法:这项前瞻性队列研究纳入了2021年4月至2022年8月接受乳房美容手术的所有连续患者。流行病学数据,麻醉,疼痛,患者满意度采用标准化自我评估问卷进行系统评估。
结果:总之,纳入48例患者[年龄中位数(IQR):30(36-25)]。最常见的手术是乳房固定术。69%的手术涉及额外的程序。平均肋间阻滞和局部麻醉时间为15分钟。患者接受的中位数(IQR)为19(34-2)mg/kg利多卡因和2.3(2.5-2.0)mg/kg罗哌卡因。异丙酚和阿芬太尼的消耗中位数(IQR)为,分别,4.89(5.48-4.26)mg/kg/h和0.27(0.39-0.19)µg/kg/min。没有发生转换为全身麻醉或计划外住院的情况。患者在中位数(IQR)为2:40(3:43-1:58)小时后出院。术后24小时内,17%需要一次止吐药物和38%的阿片类药物。患者对麻醉非常满意,并且90%的患者在最初24小时内不希望更多的镇痛。
结论:镇静下的麻醉乳房手术,肋间阻滞,肿胀麻醉可以安全地作为门诊手术进行,并且与最小的术中和术后阿片类药物消耗和高患者满意度相关。这些数据可用于告知患者和临床医生并提高整体护理质量。
方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
Comfort and recovery are major concerns of patients seeking aesthetic surgery. This study aimed to assess postoperative pain and recovery after outpatient breast surgery under sedation, intercostal block, and local anaesthesia.
This prospective cohort study included all consecutive patients who underwent aesthetic breast surgery between April 2021 and August 2022. Epidemiological data, anaesthesia, pain, and patients\' satisfaction were systematically assessed with standardized self-assessment questionnaires.
Altogether, 48 patients [median (IQR) age: 30 (36-25)] were included. The most frequent surgery was mastopexy. 69% of surgeries involved additional procedures. The mean intercostal block and local anaesthesia time was 15 min. Patients received a median (IQR) of 19 (34-2) mg/kg lidocaine and 2.3 (2.5-2.0) mg/kg ropivacaine. The median (IQR) consumption of propofol and alfentanil was, respectively, 4.89 (5.48-4.26) mg/kg/h and 0.27 (0.39-0.19) µg/kg/min. No conversion to general anaesthesia or unplanned hospital admission occurred. Patients were discharged after a median (IQR) of 2:40 (3:43-1:58) hours. Within the first 24 postoperative hours, 17% required once an antiemetic medication and 38% an opioid. Patients were very satisfied with the anaesthesia and 90% of the patients had not wished more analgesia in the first 24 h.
Aesthetic breast surgery under sedation, intercostal block, and tumescent anaesthesia can safely be performed as an ambulatory procedure and is associated with minimal intra- and postoperative opioid consumption and high patient satisfaction. These data may be used to inform patients and clinicians and improve the overall quality of care.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .