盐酸氯普鲁卡因在肿胀麻醉脂肪抽吸术中的应用  

Clinical application of chloroprocaine hydrochloride in liposuction

作　　者：马兰花[1] 李发成[1] 侯莹[1] 

机构地区：[1]首都医科大学附属北京朝阳医院整形外科,北京100020

出　　处：《中华医学美学美容杂志》2007年第4期224-226,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨盐酸氯普鲁卡因在肿胀麻醉脂肪抽吸中的应用。方法对脂肪抽吸者按美国麻醉医师协会（ASA）制定的麻醉分级为Ⅰ、Ⅱ级控制麻醉效果，以盐酸氯普鲁卡因作为局部麻醉，在肿胀麻醉下进行脂肪抽吸术。8例进行自体对照，一侧用0．06％利多卡因肿胀液麻醉，对侧用0．06％盐酸氯普鲁卡因麻醉。另3例单独用0．06％盐酸氯普鲁卡因肿胀麻醉。12例采用利多卡因与盐酸氯普鲁卡因混合液作为肿胀液的局麻药，其中利多卡因浓度为0．02％～0．04％，盐酸氯普鲁卡因的浓度为0．02％。观察生命体征（心率、血压、呼吸次数和血氧饱和度）和麻醉效果。结果盐酸氯普鲁卡因最大用量为4200mg（37．5mg／kg）。盐酸氯普鲁卡因肿胀麻醉行脂肪抽吸术，麻醉充分，麻醉起效时间短，但用只含盐酸氯普鲁卡因肿胀液进行麻醉行脂肪抽吸术，术后疼痛明显。结论盐酸氯普鲁卡因用于脂肪抽吸术，代谢快，对大量脂肪抽吸者可减少局部麻醉药中毒的风险。盐酸氯普鲁卡因与利多卡因结合应用，麻醉效果好，并可减少利多卡因的用量。Objective To evaluate the effects of chloroprocaine hydrochloride in patients undergoing liposuction. Methods Chloroprocaine hydrochloride was used in 23 ASA grade Ⅰ-Ⅱ adult patients ran- ging in age from 17 to 43 years for tumescent technique liposuction. In eight patients, liposuction areas were divided into two sides along midline, 0.06 % lidocaine was used in one side and 0.06 % chloroprocaine hydrochloride in the contralateral side. In other three patients chloroprocaine hydrochloride alone （0.06 %） was used for liposuction. Tumescent liquid, containing 0.02 %-0.04 % lidocaine and 0.02 % chloroprocaine hydrochloride, was used for liposucton in 12 patients. The vital sign （HR, Bp, RR, SpO2） was recorded. Results The maximum dose of chlorprocalne was 4200 mg （37. 5mg/kg）. Adequate intraoperative anaesthesia was achieved in all area injected with tumescent liquid containing chloroprocaine hydrochloride. The more rapid onset of regional anesthesia was recorded in the side under local anesthesia with chloroprocaine hydrochloride. Patients who were anesthetized with chloroprocaine hydrochloride alone complained of severe pain after liposuction. No complications related to chloroprocaine hydrochloride were noted. Conclusions This initial experience suggests that chloroprocaine hydrochloride offers an acceptable alternative to lidocaine for liposuction. The maior advantage of chloroprocaine hydrochloride is its rapid metabolism, which thereby minimizes the risks of toxicity, especially in patients undergoing large-volume liposuction. The combined technique may produce better anesthetic efficacy and reduce the dose of lidocaine.

关 键 词：脂肪抽吸术 盐酸氯普鲁卡因 

分 类 号：R614[医药卫生—麻醉学]