TY - JOUR

T1 - Breast augmentation under local anesthesia with intercostal blocks and light sedation

AU - Ditlev, Martine

AU - Loentoft, Erik

AU - Hölmich, Lisbet R.

N1 - Publisher Copyright: © 2022 Acta Chirurgica Scandinavica Society.

PY - 2023

Y1 - 2023

N2 - Introduction: This study of breast augmentations performed under local anesthesia with intercostal blocks and light sedation describes the outcomes and evaluates benefits and complications. Method: From December 2005 until August 2019, 335 women consecutively underwent bilateral breast augmentation procedures. The anesthetic protocol consisted of an initial intravenous bolus of 1 mg midazolam and 0.25 mg alfentanil preoperatively. In 2017, this was changed to 2–4 mg midazolam intramuscularly, 1 mg midazolam intravenously, and 2.5 µg sufentanil intravenously. Intercostal blocks were injected at the midaxillary line into the intercostal spaces two to seven. The operating field was infiltrated with tumescent local anesthesia. Retrospective data extraction from patients’ medical charts was done, registering demographics, dosage of anesthesia, surgical characteristics, complications, and reoperation rates. Results: Two hundred and eighty-one women underwent primary augmentation and 54 had implant replacement. The most common complications included suboptimal cosmetic results, asymmetry, and healing-related problems. The overall rate of reoperation was 16.1% within an average follow-up period of 2 years, ranging from 0 to 12.5 years. The majority of the reoperations were due to cosmetic reasons. The change in anesthetic regime was associated with a significantly (p < 0.0001) decreased need for supplementary medication with no increased risk of complications. Conclusion: Breast augmentations in local anesthesia with intercostal blocks and light sedation can be performed safely and can serve as an alternative to procedures in general anesthesia.

AB - Introduction: This study of breast augmentations performed under local anesthesia with intercostal blocks and light sedation describes the outcomes and evaluates benefits and complications. Method: From December 2005 until August 2019, 335 women consecutively underwent bilateral breast augmentation procedures. The anesthetic protocol consisted of an initial intravenous bolus of 1 mg midazolam and 0.25 mg alfentanil preoperatively. In 2017, this was changed to 2–4 mg midazolam intramuscularly, 1 mg midazolam intravenously, and 2.5 µg sufentanil intravenously. Intercostal blocks were injected at the midaxillary line into the intercostal spaces two to seven. The operating field was infiltrated with tumescent local anesthesia. Retrospective data extraction from patients’ medical charts was done, registering demographics, dosage of anesthesia, surgical characteristics, complications, and reoperation rates. Results: Two hundred and eighty-one women underwent primary augmentation and 54 had implant replacement. The most common complications included suboptimal cosmetic results, asymmetry, and healing-related problems. The overall rate of reoperation was 16.1% within an average follow-up period of 2 years, ranging from 0 to 12.5 years. The majority of the reoperations were due to cosmetic reasons. The change in anesthetic regime was associated with a significantly (p < 0.0001) decreased need for supplementary medication with no increased risk of complications. Conclusion: Breast augmentations in local anesthesia with intercostal blocks and light sedation can be performed safely and can serve as an alternative to procedures in general anesthesia.

KW - Breast augmentation

KW - intercostal blocks

KW - light sedation

KW - local anesthesia

U2 - 10.1080/2000656X.2022.2069789

DO - 10.1080/2000656X.2022.2069789

M3 - Journal article

C2 - 35510744

AN - SCOPUS:85132660370

VL - 57

SP - 271

EP - 278

JO - Journal of Plastic Surgery and Hand Surgery

JF - Journal of Plastic Surgery and Hand Surgery

SN - 2000-656X

IS - 1-6

ER -