Anesthesia for Rhinoplasty Fayetteville
Anesthesia for rhinoplasty is different from many other types of anesthesia techniques. Like anesthesia for other Plastic surgery procedures, the area of surgery should be without sensation for the duration of the surgery. Unlike anesthesia for many other Plastic surgery procedures, the desired changes in the nose are so small in most patients, that any distortion of the tissue from anesthesia will make the procedure more difficult. As such, the goal for anesthesia with the rhinoplasty procedure is to obtain a block of the sensation while at the same time avoiding distortion of the tissues of the nose. Anesthesia for rhinoplasty is somewhat unique because it is delivered by the anesthesia professionals and the Plastic surgeon. The anesthesia professional provides the intravenous medication and the Plastic surgeon provides the local anesthesia. In other words, anesthesia for the rhinoplasty procedure is a team approach. For most patients, a combination of intravenous sedation and local anesthesia (similar to that used by Dentists) works well. Because the intra-venous sedation is administered to the patient before the local anesthesia, the patient will experience no discomfort when it is given. The local anesthesia technique that can be used for rhinoplasty surgery is termed a field block. With this type of local anesthesia the nerves to the nose are blocked outside the area of surgery so that the tissues are not distorted. While there may be some tissue distortion from the surgery itself, by using a field block, the general anatomy of the nose can be observed during the procedure. As a result, the final aesthetic result becomes much more predictable.
Because the neuroanatomy of the nose is very complex (many different sensory nerves innervate the nose), multiple injections of local anesthetic are required. This emphasizes the importance of a thorough knowledge of the sensory nerves of the nose, which facilitates a complete anesthestic block. In addition to local anesthesia injections, topical anesthesia can also be used. Topical anesthesia means that the drug is absorbed into tissues rather than being injected.
In addition to blocking sensation to the nose, in most circumstances, a local anesthetic solution with epinephrine is used. Epinephrine is a natural vasoconstrictor (causes blood vessels to become smaller). As a result, there is less bleeding into the surgical field making structures more visible. Operating in a “bloodless field” is a basic principle of surgery that is very important during the rhinoplasty procedure.
Modern anesthesia medicines (intra-venous medicine) have a very short half life (go away quickly), have a low allergic potential (very few allergic problems), have a broad dosage curve, and are ideal for surgical procedures of this length. The short half-life of the drugs allow the patient to wake up quickly which is ideal for outpatient surgery. The low allergic potential means that the drugs are generally very safe from this standpoint. The broad dosage curve allows the Anesthesia Staff to reach the precise depth of sedation required.
In summary, modern anesthetic techniques used by qualified Anesthesia professionals during rhinoplasty make the patient very confortable and are considered very safe.
In some circumstances, general anesthesia may be required if there are concerns about compromise of the patients airway. This circumstance may arise when extensive intra-nasal surgery is required such as septal repair and/or excision of the inferior turbinate bones to treat breathing problems.