Patients thin about submitting to plastic surgery, mostly, always express great concern about the anesthesia that will be used and its risks. Because of this fear, even the anesthesia is a reason for giving up and lack of courage, especially for people over 40 years old. These, certainly have heard throughout their childhood, cases of “shock anesthesia”, in which the person “has slept and hasn’t woken up”.
The experience with anesthesia – Dr. Cassiano F. Beller
All kinds of anesthesia have their own safety characteristic, and should be decided according to the criteria of the anesthesiologist.
We know that anesthesia for plastic surgery has a high degree of security because we are operating a healthy patient, in their full health conditions, while the plastic surgery will treat only areas of the body surface (i.e. superficial). However, what impresses me most is the advancement of quality and safety of anesthesia throughout my medical life, from my period of academic training, which I had already followed surgeries of various specialties, to the present day.
I remember, in my view, general anesthesia was not so good, despite being essential for certain surgeries, it was common for the patient take long to wake up and recover from the anesthesia, besides the indisposition, nausea and vomit were very common and lasted for days to get better.
My impression at the time is that if you could perform a regional or local anesthesia, it would be safer and have more control. It was a time that there were very few monitoring devices of the vital functions of the body and it was used blood pressure cuff and control of heart rate.
By the time of my training in plastic surgery, some services associated epidural or local anesthesia with sedation for the patient to sleep and do not notice the discomfort of anesthetic application and support surgery time. The advantages are that if they would have faster postoperative, which would allow earlier discharge and a lower financial cost.
Therefore, when I started my professional career, almost all of my surgeries were performed under epidural or local anesthesia with sedation by an anesthesiologist, and always worked very well, without complications and quite safely. My preference for this type of anesthesia lasted at least 10 years.
The general intravenous anesthesia
In the early 2000s, when there was general intravenous anesthesia in our environment, there was a major breakthrough in quality and safety. This was due to the appearance of new drugs and the use of new monitoring devices in our day to day,(devices that instantly show the various important data such as, blood oxygenation, blood pressure, the degree of consciousness at the moment, etc.), and infusion pumps (devices that run continuously and steadily the necessary drugs in the blood) that led to what I call the “honeymoon” between plastic surgery and general anesthesia.
Today, despite having a cost slightly higher, it offers outstanding quality in terms of safety, patient comfort and faster postoperative recovery, so that there is less stress and allowing a waken up like a normal sleep day to day. This also allows a faster mobilization and consequent shorter hospitalization.
Today, basically, in our daily practice we have used general anesthesia (total intravenous) in almost all surgeries with outstanding satisfaction and full sense of security.
