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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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The Muscular System01:18

The Muscular System

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The muscular system is essential to the body's overall structure and function, playing a crucial role in movement, stability, and internal processes. It consists of three distinct types of muscle tissue: the skeletal, the smooth, and the cardiac muscles.
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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General Anesthesia: Overview01:24

General Anesthesia: Overview

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Sub-muscular Breast Augmentation Using Tumescent Local Anesthesia.

Alberto Bolletta1, Luca Andrea Dessy2, Luca Fiorot3

  • 1Department of Surgical, Microsurgical and Medical Sciences, Plastic Surgery Unit, University of Sassari, Via Monte Grappa 70, 07100, Sassari, Italy. alb.bolletta@gmail.com.

Aesthetic Plastic Surgery
|July 12, 2018
PubMed
Summary

Tumescent local anesthesia (TLA) is a safe and effective method for sub-muscular breast augmentation, offering excellent pain control and patient satisfaction. This technique minimizes complications and avoids the need for general anesthesia in augmentation mammoplasty.

Keywords:
Breast augmentationBreast implantsSub-muscularTumescent local anesthesia

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Area of Science:

  • Plastic Surgery
  • Anesthesiology

Background:

  • Tumescent local anesthesia (TLA) involves infiltrating tissues with a lidocaine and epinephrine solution for anesthesia and vasoconstriction.
  • While TLA has been used for sub-glandular breast augmentation, its application in sub-muscular positioning is less documented.

Purpose of the Study:

  • To describe a modified TLA technique for primary sub-muscular breast augmentation.
  • To report the clinical experience and outcomes of this technique over a 7-year period.

Main Methods:

  • A cohort of 300 patients underwent bilateral primary sub-muscular breast augmentation using TLA and conscious sedation between 2010 and 2017.
  • The tumescent solution comprised lidocaine, sodium bicarbonate, and epinephrine in saline, infiltrated first between the pectoral fascia and mammary gland, then under the pectoralis major muscle.

Main Results:

  • An average of 740 mL of tumescent solution was used per breast.
  • No instances of lidocaine or epinephrine toxicity were observed, and general anesthesia was not required.
  • Major complication rates were 3.3% (hematomas, seromas), and minor complication rates were 6.0% (implant dislocation, dystrophic scars).

Conclusions:

  • TLA is a safe and effective anesthesia technique for sub-muscular breast augmentation.
  • The procedure provides effective pain management during and after surgery with a low complication rate.
  • Patients undergoing sub-muscular breast augmentation with TLA reported high satisfaction levels.