CONTINUOUS THORACIC EPIDURAL-ANESTHESIA FOR BREAST AUGMENTATION

Thirty consecutive cases were scheduled for submuscular breast augment ation under continuous thoracic epidural anesthesia. The epidural tube was placed into the intervertebral space between the third and fourth thoracic vertebrae. An average of 15 ml of 2% lidocaine with 1:80,000 epinephrine was used as a primary anesthetic agent. There were no sig nificant changes in respiratory function; only a transient elevation o f blood pressure and increased heart rate were noted. All cases were s uccessfully anesthetized, except one case (3%) who had a partial analg esic effect and needed to combine general anesthesia. One patient need ed a single dose of ephedrine, 20 mg, to treat hypotension. Perioperat ive complications included transient shivering (33%), stuffy nose (20% ), nausea (7%), and shortness of breath (13%). These symptoms were all eviated after reassurance or light sedation and oxygen inhalation. Imm ediate postoperative pain of the operative site was effectively contro lled by injection of local anesthetics through the epidural tube. This study revealed that thoracic epidural anesthesia was feasible, effect ive, and even better than conventional alternative anesthetic techniqu es for breast augmentation.