Arch Plast Surg.  2012 Sep;39(5):540-545. 10.5999/aps.2012.39.5.540.

Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery

• Chung KJ
• Cha KH
• Lee JH
• Kim YH
• Kim TG
• Kim IG

• KMID: 2267720
• DOI: http://doi.org/10.5999/aps.2012.39.5.540

Abstract

BACKGROUND
Patients have anxiety and fear of complications due to general anesthesia. Through new instruments and local anesthetic drugs, a variety of anesthetic methods have been introduced. These methods keep hospital costs down and save time for patients. In particular, the target-controlled infusion (TCI) system maintains a relatively accurate level of plasma concentration, so the depth of anesthesia can be adjusted more easily. We conducted this study to examine whether intravenous anesthesia using the TCI system with propofol and remifentanil would be an effective method of anesthesia in breast augmentation.
METHODS
This study recruited 100 patients who underwent breast augmentation surgery from February to August 2011. Intravenous anesthesia was performed with 10 mg/mL propofol and 50 microg/mL remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 microg/mL and 2 ng/mL for propofol and remifentanil, respectively, and titrated against clinical effect and vital signs. Oxygen saturation, electrocardiography, and respiratory status were continuously measured during surgery. Blood pressure was measured at 5-minute intervals. Information collected includes total duration of surgery, dose of drugs administered during surgery, memory about surgery, and side effects.
RESULTS
Intraoperatively, there was transient hypotension in two cases and hypoxia in three cases. However, there were no serious complications due to anesthesia such as respiratory difficulty, deep vein thrombosis, or malignant hypertension, for which an endotracheal intubation or reversal agent would have been needed. All the patients were discharged on the day of surgery and able to ambulate normally.
CONCLUSIONS
Our results indicate that anesthetic methods, where the TCI of propofol and remifentanil is used, might replace general anesthesia with endotracheal intubation in breast augmentation surgery.

Keyword

Anesthesia, intravenous; Mammaplasty; Propofol; Remifentanil

MeSH Terms

Anesthesia
Anesthesia, General
Anesthesia, Intravenous
Anesthesia, Local
Anesthetics
Anoxia
Anxiety
Blood Pressure
Breast
Electrocardiography
Female
Hospital Costs
Humans
Hypertension, Malignant
Hypotension
Intubation, Intratracheal
Mammaplasty
Memory
Oxygen
Piperidines
Plasma
Propofol
Venous Thrombosis
Vital Signs
Anesthetics
Oxygen
Piperidines
Propofol