Facial Cosmetic Surgery Deserves specialized Anesthesia
I have always felt that high-quality anesthesia and sophisticated surgery go hand in hand. So many of the great advances in surgery were propelled by innovations in anesthesia. For example, until the heart-lung machine was perfected by an anesthesiologist, open heart surgery was not feasible.
In facial cosmetic surgery I believe there must be a strong emphasis and focus on the anesthesia as well as the surgery. The anesthesia service should be as specialized as the surgeon. Both, when well done, will provide a superior experience for the patient.
Outpatient anesthesia is far different from in-hospital anesthesia. There are different techniques and different drugs used. The main reason is that patients need to recover quickly and be able to return home or to a post-surgery facility in a reasonable amount of time. This requires drugs that have a short lifespan within the body and are less apt to make the patient have any side effects, such as nausea and vomiting or dizziness.
One of the leaders in the field of outpatient anesthesia has further specialized to become recognized for his work in cosmetic surgery outpatient procedures. Therefore he qualifies as a superspecialist which, I feel, is always the key to patient comfort and safety.
Dr. Barry Friedberg founded the Society for Office Anesthesiologists over ten years ago. He has been a proponent of a particular technique known as PK anesthesia which is the use of the intravenous general anesthetic propofol, as well as ketamine, which creates a trace-like state. PK anesthesia is designed to maximize patient safety while creating the illusion of the general anesthesia that would match that given by the type of anesthesia where a tube is placed into the lungs and an anesthetic gas is inhaled by the patient.
In reality, this technique puts the brain to sleep without the anesthesiologist having to control breathing, heart rate and other vital signs. The technique is reliant on the surgeon's performing a satisfactory injection of local anesthetic, so in fact the operative area is pain- free.
For the patient, the most important part of any anesthetic is that the patient has no awareness and of course, no pain. With the local anesthesia blocking pain sensation and the propofol and ketamine putting the patient to sleep and detaching the patient from the experience, all the requirements of a safe anesthetic are in place.
To monitor the level of drugs necessary to keep the patient asleep and unaware, there is a special brain wave monitor. The BIS anesthesia monitor measures brain activity under medication. Just as the cardiogram monitors heart function under the influence of heart meds.
With fewer drugs on board, the postoperative vomiting and nausea is virtually eliminated.
To learn more about Dr. Friedberg, you can visit his website at doctorfriedberg.com.
