超量灌注和肿胀麻醉在美容整形外科中的应用

Over-volume fill and tumersent anesthesia in aesthetic plastic operation

超量灌注和肿胀麻醉都是局麻方法。超量灌注法是，在做脂肪抽吸时，应用０．０４％的利多卡因加入１／１００万肾上腺素做超剂量灌注，利多卡因的最大剂量可达５２．７ｍｇ／ｋｇ。其它如乳房整形、面部除皱手术等则可采用肿胀麻醉法，即将利多卡因稀释成０．０４％～０．１％的浓度，局部大量注射，使其肿胀，但利多卡因的总量仍可保持在６．４ｍｇ／ｋｇ的常规用量范围内。本组２８１例观察，麻醉镇痛完全者２４７例，占８７．９％；局部有痛感但可以忍受者为３１例，占１１．０４％；自觉不可忍受者为３例，占１．０６％。对有痛感者给予适量镇静镇痛药，未改用其它麻醉方法。故超量灌注和肿胀麻醉的方法可以安全有效地应用于大范围的美容整形外科手术，使手术更安全、出血少，患者恢复快。

The technique of over-volume fill and tumersent anesthesia is one kind of local anesthesia, when using it exactly in aesthetic plastic operation of large body area it is safe with less bleeding and quick restoring. In liposuction, the technique of over-volume fill can be done by using 0.04% lidocaine with 1/1000000 adrenaline and the highest dosage is 52.7mg/kg. In mammaplasty or rhytidectomy, the technique of tumersent anesthetic can be used, but the total dosage of lidocaine should be confined to 6.4mg/kg. In a series of 281 cases, 247 cases(87.9%) gave satisfactory analgesic effect, incomplate analgesic effect in 31 cases(11.04%), with unbearable local pain 3 cases(1.0%). There were few complications, these technique are safe and effect in easthetic plastic surgery of a large body area . 