Anesthesia for office‐based facial plastic surgery procedures

Abstract

ObjectiveThe objective of this study is to provide a state‐of‐the‐art review on the use of anesthetics for in‐office facial plastic procedures.MethodsA search was performed on PubMed, Embase, Web of Science, and Cochrane Review using the keywords “anesthesia,” “office‐based procedures,” “local anesthesia,” “facial plastics,” “oral sedation,” “moderate sedation,” and “deep sedation.”Results and ConclusionsOver the past few decades, the shift toward in‐office invasive procedures has increased patient convenience and decreased hospital resource utilization. Many tools exist to reduce patient anxiety and discomfort in an office‐based setting. With proper patient selection and technique, facial plastic surgeons can adequately anesthetize patients to perform Mohs reconstruction, cutaneous excisions, blepharoplasty, face‐lifts, and other in‐office procedures.

Outcomes following inguinal and subinguinal urologic procedures under deep intravenous sedation

“…Despite being standard practice, both GA and SA are still associated with risks to the patient. 3,6 Still, GA and SA have been the anesthesia of choice for inguinal and subinguinal procedures as they can both effectively accommodate the perioperative stretch of the spermatic cord, which can elicit a vagal reflex with ensuing bradycardia and pain for the patient. 16 Multimodal anesthetic approaches have long been used for open inguinal hernia repairs, eliciting similar spermatic cord stimulation to the procedures investigated in our study, with minimal complications.…”

“…DIVS is often regarded as a safer alternative to GA, having shown a stronger safety profile, greater perioperative patient comfort, and improved recovery compared to traditional forms of anesthesia. 6,7 Notably, DIVS negates the need for intubation as spontaneous ventilation is maintained, reducing the risks of upper airway trauma and patient-related factors complicating anesthesia, while providing the capability of being utilized in an office-based setting under the supervision of an anesthesiologist. 8 DIVS has also been used to perform more invasive office-based procedures, reducing the use of a hospital OR and associated resources.…”

“…8 DIVS has also been used to perform more invasive office-based procedures, reducing the use of a hospital OR and associated resources. 6,9 Similar to GA, SA carries its own risks including postdural puncture headaches and urinary retention, in addition to the time required to establish successful anesthesia. 10 Currently, limited definitive evidence exists supporting the use of DIVS with LA for inguinal and subinguinal surgical approaches within urological settings.…”