Remember, if you are a healthy patient.... and you should be if considering an elective cosmetic procedure.......anesthesia is actually your friend.
Why? Sedation alleviates anxiety and provides pain relief.
The form of anesthesia I provide for my patients (with a CRNA) in my AAAASF accredited facility is very similar to what one received for a colonoscopy. Before coming to the facility, the patient receives a sublingual Emend, which allows for nausea control, and 5 mg of Valium. Upon arrival, the patient is given intravenous Versed, which takes away memory of the event, and controls anxiety. Versed is a short acting intravenous medication in the same class as Valium.
Propofol is then given intravenously in oder to allow the patient to be kept in a steady state of sedation. The patient is monitored with ekg equipment and pulse oximetry to ensure that oxygen saturations are maintained. In order to prevent a patient from becoming more awake, sedation is ensured by using a continuous intravenous pump. Fentanyl, a synthetic form of narcotic, is also used for pain relief as needed. Lidocaine and/or Marcaine are then injected into the surgical sites to further ensure pain control.
The beauty of this technique is that it allows for relief of anxiety, a dual mode pain control, and does so with medications which have a negligible cardiac effects.
Why is a local approach not always desirable? Anxiety, pain, and dangers of local anesthetic overdose. In my experience, oral Valium alone is insufficient as an anxiety reliever for most mini lift patients. Although Lidocaine shots (even when buffered) provide pain relief, they tend to burn because Lidocaine has a slightly different pH than the skin. One danger (not frequently discussed) of using a local only approach is Lidocaine and/or Marcaine overdose. Marcaine toxicity is real and potentially deadly. So, there are certainly potential drawbacks to any approach and a careful, considered discussion with your surgeon is necessary prior to making a decision.
