布比卡因和利多卡因肿胀液在局麻吸脂术中的应用效果比较

Comparison of Bupivacaine and Lidocaine Swelling Solution in Liposuction under Local Anesthesia

目的:结合在局麻吸脂术使用布比卡因的经验探讨肿胀液中布比卡因的安全使用、组成及其有效性。方法:选择2013年6月-2019年2月135例不同部位进行局麻负压吸脂的患者为研究对象,肿胀液主要成分为布比卡因和利多卡因,评估应用含布比卡因和利多卡因肿胀液在吸脂术中的药物组成、用量、疗效和安全性。结果:局麻吸脂中含布比卡因结合利多卡因的肿胀液适合于吸脂量低于4800ml的患者,仅含布比卡因一种麻醉药物的肿胀液在吸脂量为3600ml,布比卡因总用量为252mg(文献值为150mg)时未显示毒性;含布比卡因肿胀液组镇痛效果好于利多卡因组,术中起效快,术后1~4d无痛苦、恢复快、愈合好、并发症少、住院时间缩短一半。结论:布比卡因及布比卡因结合利多卡因的肿胀液在局麻吸脂中具有镇痛效果好、手术安全等优点,为其进一步应用提供了宝贵经验。证明布比卡因、尤其是布比卡因结合利多卡因作为肿胀液的麻醉药物值得进一步推广。

Objective Combined with the experience of using bupivacaine in local anesthesia and liposuction to discuss the safety,composition and effectiveness of bupivacaine in swelling fluid.Methods From June 2013 to February 2019,135 patients with different parts of local anesthesia and negative pressure liposuction were selected as the study objects.The main components of swelling fl uid are bupivacaine and lidocaine.To evaluate the composition,dosage,effi cacy and safety of bupivacaine and lidocaine in liposuction.Results The swelling fl uid contained bupivacaine combined with lidocaine in local anesthesia was suitable for patients with liposuction less than 4800ml.The swelling fl uid only contained bupivacaine anesthetic showed no toxicity when the liposuction was below 3600ml and the total amount of bupivacaine was below 252mg(ref value 150mg).There was no obvious pain sensation for 1-4d after the operation.The advantage contained bupivacaine as swelling fl uid is that the postoperative recovery is fast,the healing is good,the complications are few,and the time of hospitalization is shorten by half.Conclusion Bupivacaine as the anesthetic agent for swelling fl uid showed the advantages of long and good anesthetic effect,safe operation,and better comprehensive effect.It proves that bupivacaine,especially bupivacaine combined with lidocaine,as an important part of swelling fl uid is worth further promotion.