原名「台灣學術線上」
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dvd臺灣農村規劃的在地美臺灣獵鹿季節
   
   
   
     
   
 
項次 書目
1
題名:Local Anesthesia to Improve Postoperative Outcome for Breast Cancer Surgery: Preliminary Results    
局部麻醉應用於乳癌手術的臨床分析:初步結果
著者:Chung-Hsin Tsai(蔡崇鑫) ;Yung-Wei Hsu(徐永偉) ;Shih-Ping Cheng(鄭世平) ;Chien-Liang Liu(劉建良) ;Tsen-Long Yang(楊圳隆) ;Chun-Yueh Lin(林春月) ;Yuan-Ching Chang(張源清)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:乳癌 ; 麻醉 ; 局部麻醉 ; 全靜脈麻醉 ; 異丙酚 ; 鹽酸利多卡因 ; Breast cancer ; Quality of life ; Anesthesia ; Local anesthesia
刊名:Journal of the Chinese Oncology Society
頁碼:3-9
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

我們已經知道吸入性氣體麻醉全身麻醉在接受乳癌手術的病人上可能有術後疼痛及噁心、嘔吐的副作用。手術創傷及其壓力會引起不當免疫反應,而免疫缺損則可能促成腫瘤生長和擴散。保有完整免疫以及較好的術後生活品質被認為是微創手術的優點之一。局部麻醉可以有效阻止外科手術創傷訊息傳入,進而減少神經內分泌(neuroendocrine)、代謝、細胞激素(cytokine)的不良反應。因此,較少的發炎反應、較完整的免疫功能維持,暗示著局部麻醉較少的術後疼痛、更好的生活品質甚至更好的癌症控制。 靶控輸注系統(Target-controlled Infusion)使得以異丙酚(Propofol)為主的鎮靜麻醉更準確而有效率。本研究使用局部麻醉葯品(lidocaine, Bupivacaine)以及鎮靜麻醉葯品(Propofol)以局部麻醉應用於乳癌手術,在術中血流動力的穩定性應優於吸入性氣體麻醉。為了評估局部麻醉應用於乳癌手術的準確度與安全性,以及比較吸入性氣體麻醉與全靜脈麻醉的差異,將接受乳癌手術的病患,隨機分配接受吸入性氣體麻醉或局部麻醉合併靶控輸注系統的鎮靜麻醉。兩種麻醉方式的麻醉恢復品質、術後疼痛及生活品質分析比較後。局部麻醉應用於乳癌手術皆優於吸入性氣體麻醉。 我們大膽預測,本研究的延伸將帶來醫界重大的衝擊,提供安全、便宜、而且兼顧生活品質的乳癌手術麻醉模式。
Introduction: The purpose of this study was to determine safety and feasibility of breast surgery under local anesthesia (LA) combined with adequate sedation. Patients and Methods: Based on extensive satisfaction surveys, an anesthetic technique was developed that decreased nausea and pain, and reduced perioperative narcotic use. Using this new algorithm, patients treated by a single surgeon were given the choice of local anesthesia with adequate sedation. Results: From August 1, 2006 to December 31, 2007, 50 mastectomies or lumpectomy/axillary dissections were performed in 50 patients. Less postoperative nausea and vomiting (PONV) and less pain were noted in the LA group. Conclusions: Local block mastectomy can be safely performed. It can result in markedly improved postoperative outcome without incurring additional morbidity or mortality. Less nausea/vomiting and less pain infer better quality of cancer care and higher overall patient satisfaction.


    

本卷期目次
Journal of the Chinese Oncology Society
Treatment Outcome in Oropharyngeal Carcinoma-Preliminary Report/ Chih-Yung YangYi-Shing LeuJehn-Chuan LeeYi-Fang ChangMin-Jer HuangYu-Jen ChenHong-Wen ChenHung-Tao HsiaoChung-Ji Liu
Carcinoid Tumors of the Appendix-Experience in a Teaching Hospital/ Jiunn-Chang LinTsang-Pai LiuJee-Jen LeeChien-Liang LiuTsen-Long Yang
Transanal Local Excision of Rectal Malignant Neoplasms/ Wai-Hung LeungMing-Jen Chen
Local Anesthesia to Improve Postoperative Outcome for Breast Cancer Surgery: Preliminary Results/ Chung-Hsin TsaiYung-Wei HsuShih-Ping ChengChien-Liang LiuTsen-Long YangChun-Yueh LinYuan-Ching Chang
電腦刀立體定位放射性手術於治療第一型及第二型聽神經腫瘤之研究/ 林乾閔蔡若婷林牧熹林家瑋蘇鈺凱柯宗伯魏立邱文達張丞圭葉宜憲
家族性甲狀腺癌/ 鄭世平楊圳隆鄭國祥劉建良李居仁劉滄柏
影響臺灣地區非安寧照顧下進展性癌症病患認知預後的因素/ 陳貞秀劉莉妮徐翠霞蔣曉文雷靜怡唐秀治
原發性膽囊癌的臨床分析/ 陳志仁王蒼恩張文熊林錫泉白明忠李晉賢
A Case of Gastrointestinal Stromal Tumor (GIST) of Jejunum Presenting as Hollow Organ Perforation/ Shu-Hong ChuangHung-Bun LamChien-Liang Liu
A Disappearing Splenic Tumor on CT and MRI-A Case Report of Splenic Hamartoma/ Ming-Feng TsaiFei-Shih YangTsang-Pai LiuBe-Fong ChenTsang-En WangChien-Liang Liu
 
   
 
   

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