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Logo of archplastsurgArchives of Plastic SurgeryThis ArticleFor Contributorse-Submission
Arch Plast Surg. Sep 2012; 39(5): 540–545.
Published online Sep 12, 2012. doi:  10.5999/aps.2012.39.5.540
PMCID: PMC3474413
Usefulness of Intravenous Anesthesia Using a Target-controlled Infusion System with Local Anesthesia in Submuscular Breast Augmentation Surgery
Kyu-Jin Chung,1 Kyu-Ho Cha,2 Jun-Ho Lee,corresponding author1 Yong-Ha Kim,1 Tae-Gon Kim,1 and Il-Guk Kim1
1Department of Plastic and Reconstructive Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
2Logos Aesthetic Surgery Clinic, Daegu, Korea.
corresponding authorCorresponding author.
Correspondence: Jun-Ho Lee. Department of Plastic and Reconstructive Surgery, Yeungnam University Hospital, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: +82-53-620-3480, Fax: +82-53-626-0705, psjhlee/at/
Received May 31, 2012; Revised August 14, 2012; Accepted August 14, 2012.
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.
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 µg/mL remifentanil simultaneously administered using two separate modules of a continuous computer-assisted TCI system. The average target concentration was set at 2 µg/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.
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.
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.
Keywords: Anesthesia, intravenous; Mammaplasty; Propofol; Remifentanil
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Korean Society of Plastic and Reconstructive Surgeons