2017年八月最新論文
隆乳術後的疼痛，常讓不少女性畏懼，但目前已有許多方式可以大大的減緩術後庝痛。其中肋間神經阻斷術是吳至偉醫師認為較重要的一個步驟，只要熟悉肋間神經相關的解剖構造，就能安全的施打肋間神經阻斷術，有效的緩解隆乳後的疼痛，而這也是吳醫師行之有年的隆乳手術日常。而這樣的作法，亦有相關的醫學文獻佐證其療效；下列文章為2017年8月刊登於Aesthetic Plastic Surgery期刊的論文，描述的即是吳醫師常用的隆乳後止痛方式。
Postoperative Pain Control by Intercostal Nerve Block after AugmentationMammoplasty.
此篇文章主題為：隆乳術後使用肋間神經阻斷術來緩解疼痛；下為英文摘要厡文
英文摘要原文
Aesthetic Plast Surg. 2017 Aug 8. doi: 10.1007/s00266-017-0
Abstract
BACKGROUND:
In breast augmentation with implant, there is severe pain due to damage from expansion of breasttissue and the pectoralis major. Therefore, the authors conducted this study to analyze the effectiveness of postoperative intercostal nerve block (ICNB) in reducing postoperative pain after breast augmentation with implant.
METHOD:
Forty-four female patients were enrolled in the study. Just before awaking from general anesthesia, 34 cases were injected with 0.2% ropivacaine to both third, fourth, fifth, and sixth intercostal spaces. We compared them (ICNB group) with the control group for VAS scores at the time of arrival in the recovery room, after 30, 60, and 120 min.
RESULT:
The average VAS scores per time of the control group and ICNB group were 7.1 ± 0.74 and 3.50 ± 1.81 at arrival time in the recovery room, 7.00 ± 0.67 and 3.03 ± 1.47 after 30 min, 5.50 ± 0.71 and 2.68 ± 1.49 after 60 min, and 4.60 ± 0.84 and 2.00 ± 1.35 after 120 min. VAS scores of two groups were significantly different at each time and decreased overall. Also, time and group effect of the two groups were significantly different, especially between 30 and 60 min.
CONCLUSION:
ICNB just before awaking from general anesthesia showed a statistically significant reduction in VAS score, and this means postoperative pain was reduced effectively and time to discharge could be shortened. Therefore, it can be a good way to reduce postoperative pain after augmentation mammoplasty with implant.
Abstract
BACKGROUND:
In breast augmentation with implant, there is severe pain due to damage from expansion of breasttissue and the pectoralis major. Therefore, the authors conducted this study to analyze the effectiveness of postoperative intercostal nerve block (ICNB) in reducing postoperative pain after breast augmentation with implant.
METHOD:
Forty-four female patients were enrolled in the study. Just before awaking from general anesthesia, 34 cases were injected with 0.2% ropivacaine to both third, fourth, fifth, and sixth intercostal spaces. We compared them (ICNB group) with the control group for VAS scores at the time of arrival in the recovery room, after 30, 60, and 120 min.
RESULT:
The average VAS scores per time of the control group and ICNB group were 7.1 ± 0.74 and 3.50 ± 1.81 at arrival time in the recovery room, 7.00 ± 0.67 and 3.03 ± 1.47 after 30 min, 5.50 ± 0.71 and 2.68 ± 1.49 after 60 min, and 4.60 ± 0.84 and 2.00 ± 1.35 after 120 min. VAS scores of two groups were significantly different at each time and decreased overall. Also, time and group effect of the two groups were significantly different, especially between 30 and 60 min.
CONCLUSION:
ICNB just before awaking from general anesthesia showed a statistically significant reduction in VAS score, and this means postoperative pain was reduced effectively and time to discharge could be shortened. Therefore, it can be a good way to reduce postoperative pain after augmentation mammoplasty with implant.
2017年8月Aesthetic Plastic Surgery論文指出，肋間神經阻斷可有效的減少隆乳手術後的疼痛
中文簡譯
此篇論文主旨在討論隆乳術後何種方式可減少疼痛，作者在隆乳手術患者甦醒前，使用Ropivacaine在第3，4，5，6肋間施行肋間神經阻斷術 (Intercostal Nerve Block)，在44位接受隆乳患者中，有34位接受肋間神經阻斷術，另外10位則沒有接受肋間神經阻斷術，術後則以不同時間點的疼痛指數(VAS)來比較差異性。結果發現接受肋間神經阻斷術的34位，有明顯較少的疼痛，這代表著接受肋間神經阻斷術的隆乳患者，可以較快返家且有較少疼痛。
吳至偉醫師經驗
隆乳術後的疼痛，常讓不少女性畏懼，但目前已有許多方式可以大大的減緩術後庝痛。其中肋間神經阻斷術是吳至偉醫師認為最重要的一個步驟，只要熟悉肋間神經相關的解剖構造，就能安全的施打肋間神經阻斷術，有效的緩解隆乳後的疼痛，而這也是吳醫師行之有年的隆乳手術日常。
產後乳房萎縮，以圓形果凍矽膠完成隆乳
水滴形果凍矽膠隆乳
圓形果凍矽膠+自體脂肪隆乳
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