Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

Abstract

BackgroundPatients 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.MethodsThis 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.ResultsIntraoperatively, 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.ConclusionsOur 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.

Hiệu quả gây mê mask thanh quản trong phẫu thuật nâng ngực băng túi độn

“…Để vô cảm cho phẫu thuật thẩm mĩ đặt túi ngực, các bác sĩ gây mê có thể lựa chọn nhiều phương pháp như gây tê tại chỗ bằng dung dịch "Tumescent", gây tê tại chỗ kết hợp an thần hoặc gây mê nội khí quản [1], [2]. Trong đó gây mê nội khí quản (NKQ) được bác sĩ gây mê sử dụng nhiều hơn cả bởi phương pháp này có nhiều ưu điểm như khách hàng được gây mê sâu, giảm đau, giãn cơ, kiểm soát tốt hô hấp tạo điều kiện thuận lợi và an toàn cho phẫu thuật viên thao tác phẫu thuật.…”