Most revision rhinoplasty surgery is performed under general anesthesia. The advantage of general anesthesia is that it allows the patient to be maximally comfortable during the procedure. This also allows the surgeon to focus completely on what needs to be done during the surgery, while an anesthesiologist is closely monitoring the patient’s vital signs such as heart rate, blood pressure, and oxygen levels. Modern general anesthesia is extremely safe and well tolerated by the vast majority of patients. In patients over 55 years of age or those with a cardiac history, additional clearance such as an EKG and blood tests may be needed for medical clearance.
In cases in which a small amount of revisionary work is needed, Dr. Mehta often employs light IV sedation, also called twilight anesthesia. This involves the administration of an IV pain medication such as Fentanyl and a sedative such as Versed. This is the type of anesthesia used commonly during dental procedures or colonoscopies. After the patient is groggy, the nose is numbed with the injection of local anesthesia (lidocaine with epinephrine), which prevents patient discomfort and also reduces bleeding by shrinking the blood vessels. This type of sedation can be an excellent option for shorter cases in which a closed (endonasal) approach is used and primarily tip work is required. This approach also typically ends up being less expensive for the patient, as an ACLS-trained nurse is providing the sedation rather than an anesthesiologist. However, the patient’s vital signs such as heart rate, blood pressure, and oxygen level are still continuously monitored.
If you still want to learn more about anesthesia, contact us today.