Office-Based Outpatient Plastic Surgery Utilizing Total Intravenous Anesthesia

Failey, Colin; Aburto, Jaime; Portilla, Hector Garza de la; Romero, Jorge Francisco; Lapuerta, Leo; Barrera, Alfonso

doi:10.1177/1090820x12472694

Cited by 30 publications

(15 citation statements)

References 2 publications

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“…8). 25,28–33 The theory is that avoiding muscle paralysis prevents blood pooling in the lower extremities, 7,30,31 reducing the opportunity for venous stasis—a known factor implicated in thromboembolism. 27 …”

Section: “Safe” Anesthesiamentioning

confidence: 99%

The Case against Chemoprophylaxis for Venous Thromboembolism Prevention and the Rationale for SAFE Anesthesia

Swanson

2014

Plastic and Reconstructive Surgery Global Open

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Summary:The Venous Thromboembolism Prevention study concludes that anticoagulation is effective in reducing the risk of thromboembolism in patients who are identified as higher risk by Caprini scores. This report critically assesses the statistics used in the Venous Thromboembolism Prevention study, its method of data presentation, and its conclusions. The usefulness of risk stratification and the value of anticoagulation—both prevailing concepts in risk reduction today—are challenged. Actual data show that chemoprophylaxis has no proven benefit in plastic surgery. Complications of anticoagulation predictably include excessive bleeding and hematomas, which may be serious and life-threatening. Several large published series of patients undergoing elective plastic surgery under total intravenous anesthesia have shown a much reduced risk of thromboembolism. A SAFE (Spontaneous breathing, Avoid gas, Face up, Extremities mobile) anesthesia method is discussed as a safer and more effective alternative to traditional general endotracheal anesthesia and anticoagulation. The choice for plastic surgeons is not between a venous thromboembolism and a hematoma. The choice is between a thromboembolism and adjusting our anesthesia and surgery habits to reduce the risk to a baseline level.

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Section: “Safe” Anesthesiamentioning

confidence: 99%

The Case against Chemoprophylaxis for Venous Thromboembolism Prevention and the Rationale for SAFE Anesthesia

Swanson

2014

Plastic and Reconstructive Surgery Global Open

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“…[13][14][15][16][17][18] Although the shift toward ambulatory surgery has occurred across numerous surgical specialties in the United States, no other field embodies this transition better than plastic surgery, with recent reports indicating that over 80 percent of aesthetic plastic surgery operations use outpatient facilities. 19 Outpatient procedures present a variety of appealing options to patients and physicians, including reduced health care costs, comfortable operative settings, and consistent nursing and anesthesia care.…”

mentioning

confidence: 99%

Predictors of Readmission after Outpatient Plastic Surgery

Mioton

Buck

Rambachan

et al. 2014

Plastic and Reconstructive Surgery

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Unplanned readmission after outpatient plastic surgery is infrequent and compares favorably to rates of readmission among other specialties. Obesity, wound infection within 30 days of the index operation, and American Society of Anesthesiologists class 3 or 4 physical status are independent predictors of readmission. As procedures continue to transition into outpatient settings and the drive to improve patient care persists, these findings will serve to optimize outpatient surgery use.

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“…It must be done by an anesthesiologist and goes from simple monitoring of the patient to the use of intravenous drugs and local anesthetics for longer procedures as rejuvenation facial surgery. The most used drugs are propofol, ketamine, midazolam, fentanyl, sufentanil, remifentanil, and dexmedetomidine always supplemented with nasal oxygen [34][35][36][37][38][39]. Figure 1 shows a schema where the difference between alertness, conscious sedation, deep sedation, and general anesthesia are shown.…”

Section: Anesthesia Techniquementioning

confidence: 99%

Perioperative Complications in Plastic Surgery

Whizar-Lugo¹,

Campos-León²,

AlejandroMoreno-Guillen³

2019

Anesthesia Topics for Plastic and Reconstructive Surgery

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Anesthetic complications in the perioperative period in plastic surgery are extremely rare, although they can be catastrophic and sometimes fatal. The proper selection and correct preoperative assessment of patients are the key to stay away from unwanted events. Preanesthesia evaluation is mandatory in each patient and must include clinical history, complete physical examination, and routine and special laboratory tests in patients with associated pathologies. Anesthetic management is based on these results, type of surgery, experience of the anesthesiologist, and the operating environment. The anesthetic technique can be local, regional, or general with standard noninvasive monitoring. It is recommended that an anesthesiologist be present in all plastic surgery procedures. Complications are usually the result of moving away from the guidelines already established for an excellent practice or the result of sentinel events rather than human errors. Pulmonary embolism is probably the most feared complication, with soft tissue infections being the most frequent complication in plastic surgery. Less common complications include arrhythmias, overhydration, allergies, bleeding, skin necrosis, dehiscence of wounds, brain damage, and dead. Anesthesiologists, surgeons, nurses, and all personnel involved in the care of these patients must work as a team of highly qualified and updated professionals.

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Office-Based Outpatient Plastic Surgery Utilizing Total Intravenous Anesthesia

Abstract: 4.

Cited by 30 publications

References 2 publications

The Case against Chemoprophylaxis for Venous Thromboembolism Prevention and the Rationale for SAFE Anesthesia

The Case against Chemoprophylaxis for Venous Thromboembolism Prevention and the Rationale for SAFE Anesthesia

Predictors of Readmission after Outpatient Plastic Surgery

Perioperative Complications in Plastic Surgery

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