A little about anesthesia: the choice of anesthesia for plastic surgery

Plastic surgery differs from other surgical interventions in that it is performed not for medical reasons, but for aesthetic reasons. Therefore, the patient always becomes one of the parties to the discussion of the upcoming operation, the surgeon, for his part, determines the indications for the operation and chooses the optimal method for its implementation. The third party in the discussion of the future of surgical intervention is the anesthesiologist, whose task is to weigh all the risks and choose the most appropriate type of anesthesia. What he chooses and on what grounds, our portal found out.

Different types of anesthesia and principles for choosing optimal anesthesia

Any plastic surgery, even one that the patient himself considers quite simple – this is a serious stress for the body, therefore, before finally assigning its terms, the doctor sends the patient for a deep medical examination – analyzes, functional studies of the body, a detailed conversation with the therapist and anesthetist, anamnesis.

Based on the results of the examination, the anesthesiologist evaluates all the risks and selects the appropriate type of anesthesia depending on the planned operation, it is he who is responsible for the safety of the patient and for favorable conditions for the surgeon during the plastic surgery.

The following types of anesthesia can be used during plastic surgery.

• General anesthesia. Usually it is called anesthesia, with this type of anesthesia, the patient's consciousness is completely turned off, sensitivity and breathing are suppressed. The life support of the organism is carried out through a laryngeal mask or an endotracheal tube with artificial ventilation of the lungs, which of the options to prefer – decided by the anesthesiologist. An endotracheal tube is placed in the larynx to separate breathing and prevent stomach contents from entering the lungs; a mask is placed on the pharynx, eliminating irritation of the respiratory tract. Many practitioners consider this pain relief option to be the most effective and safest.
• Intravenous anesthesia. The patient is also unconscious, but natural spontaneous breathing is preserved. This type of anesthesia is preferable for long and extensive surgical interventions, since it allows you to dose anesthetic drugs and inject them into the blood in different volumes, at different speeds throughout the operation.
• Regional anesthesia. It is also called epidural or spinal. The patient remains conscious and breathes normally. The analgesic effect is achieved by disrupting the conduction of a particular nerve or nerve plexus. At the request of the patient, anesthesia can be supplemented with sleeping pills, since the ability to hear and sometimes even see the actions of the surgeon causes strong emotional experiences.
• Local anesthesia. Anesthesia is achieved by blocking the receptors of nerve endings, small nerves in the area of ​​intervention or nerve trunks and plexuses above the area of ​​intervention. The anesthetic is either applied to the skin or injected. Local anesthesia is used for small and short-term interventions. They are well known to everyone who had to remove teeth or open boils.

The choice of anesthesia method depends not only on the patient's condition, but also on the type of plastic surgery. For example, for facial plastics, general anesthesia with the introduction of an endotracheal tube is used, but for blepharoplasty, a laryngeal mask is more often preferred. Intimate plastic surgery is performed using regional anesthesia, supplementing it with intravenous sedatives.

Anesthesia drugs: what is used in plastic surgery

The anesthesiologist accompanies the patient from the beginning of plastic surgery to the end of the postoperative period. Until the patient is completely anesthetized and asleep, the surgeon will not begin the operation. Further, throughout the entire surgical intervention, the anesthesiologist ensures that painkillers, sleeping pills and other necessary drugs enter the patient's body, maintaining their concentration in the blood at a certain level, while simultaneously monitoring the work of all organs and systems.

The following types of painkillers are used to provide anesthesia:

• intravenous painkillers;
• intravenous sleeping pills;
• inhalation gases with analgesic, sedative effect;
• drugs with muscle relaxation effect.

When the surgeon finishes his work, the anesthesiologist gradually reduces the concentration of drugs in the blood and stops their supply, after which the patient gradually comes to his senses.

After the operation, the doctor continues to monitor the patient's well-being after anesthesia for some time.

Even with careful preparation for plastic surgery, there are risks of developing a response to surgical intervention – for example, fainting, a sharp drop in blood pressure, so the anesthesiologist accompanies the patient in the postoperative period.

It is important to remember that the risks of anesthesia and the operation itself should not exceed the aesthetic results for which the surgical intervention is performed, they must be minimized.