I want a nose job - but am afraid of general anesthesia because of Ritalin. Is general anesthesia w/o muscle relaxants possible?

Question

Been thinking about a nose job for quite a long time now & finally reached the conclusion that I do want 1. My problem is I'm afraid of anesthesia awareness! I know it only happens to 1-2 per 1000 but it still scares me. Mainly because I'm on Ritalin & have been so for 6 years. I've read several scientific articles about the fact that Methylphenidate makes rats wake up faster from anesthesia. I'd love to hear your experiences regarding anesthesia & a long term use of Ritalin. Any precautions?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. In my practice, I use general anesthesia for my rhinoplasty patients.  This is performed by a board-certified MD anesthesiologist.  It is extremely safe when performed in this manner.  Your questions would be most accurately addressed by your anesthesiologist.  
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Clyde Mathison, MD · Answer

Personally, I have had no issues with patients on Ritalin and anesthesia.  This question, however, is best answered by an anesthesiologist.  I recommend voicing your concerns with your rhinoplasty surgeon.  Their office can likely arrange for you to meet the anesthesiologist prior to surgery.  Best of luck!

Steven Wallach, MD · Answer

My board certified anesthesiologists account for a patient's medication  so that this does not happen. Best of luck with your decision to have a rhinoplasty.

J. Charles Finn, MD · Answer

In my practice, I use exclusively deep sedation anesthesia for rhinoplasty. This type of anesthesia is very comfortable for patients, and patients tend to bleed and bruise less. Also recovery from anesthesia is easier with less nausea. Seek a rhinoplasty expert who regularly uses this type of anesthesia. Most importantly, seek a surgeon with rhinoplasty as a main speciality for best results.

William Portuese, MD · Answer

General anesthesia is very safe today when performed by a board certified physician anesthesiologist.  We did not perform IV sedation for rhinoplasty.  It is important not to have conscious awareness of the procedure and have a controlled airway so that blood does not go down the back of the throat and into the lungs.  For more information and  many  before and after examples, please see the link and the video below

Laxmeesh Mike Nayak, MD · Answer

It is possible to have rhinoplasty without general anesthesia and still be very comfortable.  In my practice, rhinoplasty  is routinely performed under deep sedation. We use a brain monitor to measure the level of consciousness, and minimize the chance of any recollection at all. So far, over many years, we have had no intraoperative awareness at all.  Unfortunately, even with a brain monitor, this could never be 100% guaranteed with any type of anesthesia.

Anup Dhir, MD · Answer

Thank you for your question. This question can be best answered by an anaesthetist.Please take an appointment to see one and satisfy yourself before going in for an elective procedure like rhinoplasty.

I want a nose job - but am afraid of general anesthesia because of Ritalin. Is general anesthesia w/o muscle relaxants possible?

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