双侧大腿环形吸脂术中肿胀麻醉利多卡因用量研究.doc

双侧大腿环形吸脂术中肿胀麻醉利多卡因用量研究[摘要]目的:探讨局部肿胀麻醉技术下进行双侧大腿环形吸脂手术中利多卡因用量及是否存在中毒反应。方法:148例全部为女性,年龄19～56岁,平均(30.01±7.91)岁,肥胖指数 13.43～43.59,平均23.37±6.82。采用左大腿前、右大腿前、左大腿后、右大腿后侧四个部位环形序贯吸脂术,统计手术中肿胀液的注射量、利多卡因用量以及吸出脂肪和肿胀液数量。连续观察术中、术后病人的临床反应和生命体征。结果:肿胀液注入皮下脂肪数量为3 000～9 000ml, 平均(6 009.80±1 482.51)ml。吸出皮下脂肪数量 1 500～7 000ml, 平均(3 105.74±1 068.24)ml。术中抽出肿胀液200～3 300ml, 平均(1 312.50±549.92)ml,约占注入量的5%～41.67%,平均(21.84±6.95)%。注入皮下脂肪之利多卡因剂量为 27.69～88.42 mg/kg,平均(59.45±13.62)mg/kg。术中出血极少,生命体征稳定,术中及术后未见眩晕、耳鸣、幻听、金属味、口周麻木、定向障碍、抽搐、惊厥等利多卡因药物中毒的临床症状。术后站立包扎时个别患者有体位性低血压表现,平卧即可恢复正常。术后大腿围径和形态均有不同程度改善,效果满意。结论:在双侧大腿环形吸脂手术中,采用分部位序贯吸脂方法,可以有效避免利多卡因中毒发生,达到安全有效的结果。 [关键词]肿胀麻醉; 大腿; 环形吸脂; 利多卡因; 中毒 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)01-0009-03 Analysis of total lidocaine dosage in the infiltrated tumescent solutions during bilateral circumferential thigh liposuction surgery LI Yue-jun, LV Xiao-xing, LI Jing, LI Jin-qing, JIANG Li, LI Xue-yong, LI Wang-zhou (Department of Plastic and Burns, Tangdu Hospital, Fourth Military Medical University, Xi’an 710038,Shaanxi,China) Abstract: Objective To study the total lidocaine dosage used during bilateral circumferential thigh liposuction surgery under local tumescent anesthesia in combination with clinical observation of lidocaine toxic reaction in the patients. MethodsA total of 148 female patients ranging in age from 19 to 56 years with BMI 13.43～43.59 received bilateral thightumescent liposuction procedures. The infiltrating of tumescent solution and aspirating of subcutaneous adipose were carried out sequentially by four areas. The volume of swelling liquid injected, lidocaine dosage, as well as the amount of fat aspirated was recorded, and the patient’s clinical response and vital signs were continuous observed. Results The volume of tumescent solutions infiltrated into bilateral thigh subcutaneous fat ranged from 3 000 to 9 000 ml containing lidocaine dosage 27.69～88.42 mg/kg b.w. The amounts of supranatant and infranatant aspirates were 1 500 to