Anesthesia
Local Anesthesia
Much of plastic surgery is done with local anesthesia.
Medicine (usually Lidocaine a cousin of Novocain) is injected under
the skin to numb tissues. This medicine impairs nerve function. Feeling
disappears quickly. You may still feel pressure and movement of tissues
as these sensations are harder to block.
Several techniques can minimize the discomfort
of the injection. Skinnier needles enter the skin with less pain.
A longer needle can reach a wider area requiring fewer skin punctures.
Buffering the Lidocaine with a base can lessen the burning sensation
that frequently occurs. Slower injections hurt less.
Local Anesthesia with Sedation
Sedation is an alteration of your senses. Although
awake, you may be given medications by mouth or in a vein that will
lessen your ability to perceive what you are going through. This may
include a mixture of medications The local anesthesia is injected
after the sedation begins. Depending on the type of sedation, many
do not remember the operation. Sedation takes some time to wear off.
You may need a short period of observation after surgery as you recover.
The observation is usually first in a recovery area and then on the
ambulatory floor. Do not plan much for the remaining part of the day
as you recover. We prefer our patients to arrange to be with someone
and not alone during their recovery.
General Anesthesia
Larger operations are usually done with general
anesthesia where you are asleep during surgery. The anesthesiologist
usually mixes several medications that are given through an intravenous
line and others that you breath. A tube brings air through your mouth,
back behind your throat and into your trachea (breathing pipe). Your
body takes some time to recover from anesthesia. After surgery you
will go to the recovery room and then to the floor. General anesthesia
can be used on patients who leave the hospital the same day or stay
overnight. Different medicines take different intervals to wear off.
Some general anesthetic medications may take several days for all
of the effects to have worn off. The back of your throat may be sore
from the tube that was protecting the airway. This soreness usually
goes away in a day or so.
Monitors
We watch our patient with several devices. Not
all local anesthesia cases require all types of monitoring.
A finger or toe rests in a small warm clip that
shows the level of oxygen in your body and your pulse. This pulse
oxymeter uses a red light that generates the small amount of heat.
We try to keep you from moving this clip too much since it confuses
the machine's pulse reading.
A blood pressure cuff around an arm or leg takes
your blood pressure. Many machines are automatic reinflating the cuff
every so often. The first measurement may have a higher pressure than
the rest as the machine learns what range it must use for you.
A series of small pads on the chest or sides with
wires attached connect to an electrocardiogram monitor. This more
advanced monitoring is a more accurate way to follow a pulse than
the pulse oxymeter. The EKG monitor also lets us see the electrical
signals look like coming from the heart.
Anesthesia for Plastic Surgery
Surgical Craftsmanship 
