Breast Diseases Clinical Trial
Official title:
Monitored Anesthesia Care Using Remifentanil and Ketofol Results in a Superior Quality of Recovery Compared With Total Intravenous Anesthesia in Ambulatory Breast Augmentation
hypothesis: the combination of LA with remifentanil and ketofol [monitored anesthesia care (MAC)] for ambulatory breast augmentation may result in results in better QoR on day of surgery as compared with total i.v. anesthesia (TIVA) . The purpose of this study was to compare the QoR after MAC using remifentanil and ketofol with TIVA during ambulatory breast augmentation .
Breast augmentation surgery is commonly performed on an ambulatory basis under under general
anesthesia (GA) with propofol and remifentanil or local anesthesia (LA). Although surgeons
perform this operation comfortably under GA, Patients have anxiety and fear of complications
due to GA. In addition, they expect a good postoperative quality of recovery (QOR) including
ability to resume common activities (work and daily activities) without suffering from
moderate to severe pain.
The LA is advantageous over GA in that airway instrumentation is not necessary, favorable
recovery profile, decrease postoperative pain and vomiting, increase patient satisfaction and
decrease the cost . However, patient anxiety or pain often leading to conversion of LA to GA,
which suggests the concomitant use of i.v. sedatives and analgesics as a supplement to LA.
The combination of remifentanil and ketofol (propofol, ketamine) for sedation during regional
anesthesia and LA has been shown to be a safe, effective technique, capable of maintains
adequate analgesia with conscious sedation, haemodynamic stability, and achieves lower
incidence of postoperative nausea and vomiting with shorter recovery times.
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