The use of anesthesia in modern plastic surgery

Any, even the simplest, plastic surgery is a serious stress for the body. Therefore, together with the surgeon, another doctor always works in the operating room – an anesthesiologist whose task is to create comfortable conditions not only for the patient, but also for the work of the surgeon. In addition, it is this specialist who is responsible for the safety of the patient during the operation and immediately after it, observing all the vital functions of the body. Frau Clinic anesthesiologist Olesya Dmitrievna Regotun tells more about the features of her profession and the nuances that are important for future patients.

– It is well known that the indications for surgery are determined by the surgeon, and the possibility or impossibility of anesthesia – anesthetist. Before a person goes for surgery, an anesthesiologist must conduct a conversation with him. Having assessed and weighed all the risks, he selects the necessary type of anesthesia – depending on what kind of operation is planned, on the basis of analyzes and functional studies of the body (ECG, X-ray), as well as based on the opinion of the therapist. Only after that we make a final decision on the possibility of carrying out one or another type of anesthesia and set the day of the operation.

What types of anesthesia are there?

– For surgical operations, the following types of anesthetic aids are used:

1. General anesthesia, which is performed with the installation of a laryngeal mask or with tracheal intubation and mechanical ventilation (artificial lung ventilation) 
   The main difference between general anesthesia and other options – in the fact that the patient's consciousness is completely turned off, sensitivity is lost and all reflex reactions of the body, including breathing, are suppressed. Depending on the degree of respiratory failure, the anesthesiologist decides on the method of ensuring the patency of the airway: an endotracheal tube or a laryngeal mask. The endotracheal tube is placed directly in the larynx. Its main task – uncoupling the breath to prevent the risk of gastric contents entering the lungs. The mask is made of thin soft latex, is located on the throat and does not penetrate into the larynx, which eliminates irritation of the patient's respiratory tract. Many patients are wary of general anesthesia, but in practice it is considered one of the most effective and safest methods of pain relief.
2. Intravenous anesthesia with spontaneous breathing In this case, the patient is also unconscious, but breathing naturally.
   This type of anesthesia is justified during long-term operations, as it makes it possible to dose anesthetic drugs into the blood at a certain rate throughout the entire surgical intervention.
3. Regional anesthesia (spinal and epidural) 
   The effect of anesthesia is achieved by turning off conduction in a specific nerve or nerve plexus. The person is conscious and breathes naturally. The main nuance when using this type of anesthesia is that the patient may have strong emotional experiences: he, as it were, "participates" in during his operation, he observes the work of the surgeon, which often causes psychological discomfort. Therefore, in some cases, the patient is additionally (optionally) given sleeping pills, which allows you to sleep peacefully in the operating room and not experience stress from what is happening.
4. Local anesthesia with anesthetic accompaniment 
   This type of anesthesia, for sure, each of us has encountered: tooth extraction, medical manipulations at the gynecologist, swallowing a probe for diseases of the gastrointestinal tract, etc. It is widely used for minimal surgical interventions, for example, when opening boils. 

Most plastic surgeries are performed under general anesthesia, commonly referred to as narcosis. But the final choice of the type of anesthesia always remains with the anesthesiologist, who is guided not only by the patient's health indicators, but also by the type of operation. For example, blepharoplasty (eyelid surgery) is most often performed under general anesthesia with the installation of a laryngeal mask, for other facial operations, general anesthesia with tracheal intubation is used, but for intimate plastic surgery, regional anesthesia with intravenous sedation is preferred.

Anesthetic drugs

There are several varieties of "professional" painkillers:

• preparations for intravenous administration, which may have a hypnotic effect, an analgesic effect, or a combination of both,
• inhalation gases, which also combine hypnotic and analgesic effects,
• drugs that relax muscles.

Throughout the operation, hypnotics and painkillers are delivered to the patient's body at a certain rate through intravenous and inhalation access. In this way, their concentration in the blood is maintained at a certain level, providing the patient with sleep and pain relief. After the end of the operation, the anesthesiologist stops the administration of drugs, their concentration decreases, and the person comes to his senses (usually this happens quite quickly, within 10 minutes).

"It is important to note that until a person falls asleep and is not anaesthetized, the operation does not start, – specifies Olesya Regotun – When the surgeon's work is over, the anesthesiologist prepares the patient for awakening, providing him with a comfortable state of health on the "exit" ; from anesthesia, as well as during the immediate postoperative period, and accompanies him to the ward. "

Key risks associated with anesthesia

«Any planned operation, especially of an aesthetic nature, is always carried out against the background of the most favorable physical (somatic) and psychological state of the patient, – emphasizes Dr. Regotun. – During the mandatory consultation with the anesthesiologist, the risks associated with the patient's health are determined, my job is to reduce them to a minimum. Therefore, unfortunately, it also happens that the desired operation is impossible or postponed: for example, when additional examinations or even treatment are needed, which will reduce the likelihood of various complications. After all, aesthetic surgery is not performed for medical reasons, so it is especially important here that the risks of anesthesia do not exceed the risks of the operation itself.

Unfortunately, many plastic surgeons disregard medical standards and operate on their own, without the participation of an anesthesiologist. The danger lies in the fact that the patient's body may begin responses to surgical trauma, such as a decrease in pressure, fainting, which can become a serious threat to health and even lead to death. Therefore, when choosing a clinic, due attention should be paid not only to the operating surgeon, but also to the team of anesthesiologists who, in case of unforeseen circumstances, can save your life.

According to http://www.tecrussia.ru/