How is General Anesthesia Given?

How is general anesthesia given when getting rhinoplasty? I know there are IVs and shots involved, both of which I am very afraid of. Can you tell me a bit more about IVs? My mother told me it's supposed to go inside your hands the whole time?! I highly doubt this but are there any alternatives that might be better? Please if you can, explain the whole process and how much it hurts. Thanks!

Doctor Answers 7

Don't be scared

General anesthesia involves a number of drugs given in my hospital (St Vincent in Worcester) by a team comprised of a board certified anesthesiologist and a certified nurse anesthetist.  Often it starts with a pill to calm your nerves.  Then they put an intravenous line in your hand.  The initial prick hurts for just a second or so.  Once the line is in, you will not feel it.  This then enables them to give any number of appropriate drugs as sort of a "cocktail" to help keep you asleep and have no memory of the procedure.  You will also be given an anesthetic gas through a tube in your mouth.  Sometimes this tube goes into your trachea (endotracheal tube); sometimes it connects to a ballon like mask that sits on top of your voice box (laryngeal mask or LMA).  I am very particular about the anesthesia my patients receive.  I want this to be as pleasant an experience as possible. I do not want them to have an nausea after surgery.  So, you will also be given drugs to prevent nausea, by vein and by mouth.  In addition, you will have a patch on your neck of scopolamine; the same patch some people use on cruises.  Call me if you have any further questions.  617 247 0033 508 363 6500

Boston Facial Plastic Surgeon
4.5 out of 5 stars 25 reviews

Anesthesia for Rhinoplasty

General anesthesia is given by an anesthesiologist or a board certified nurse anesthetist as well, depending on the facility. General anesthesia is administered by having the patient under anesthesia for sedation and then a breathing tube will be appropriately placed and secured down into your throat.Your anesthesia and your breathing is then monitored by the anesthetic machine

Kim-Chi Vu, MD
Portland Plastic Surgeon
5.0 out of 5 stars 8 reviews

General Anesthesia during Rhino

General anesthesia starts with an IV placed into the vein in the arm. Depending on how good your veins are this usually is a very smooth procedure and an only a little stick to get the needle in. Sometimes the nurses or anesthesiologist  will numb your skin with a very tiny needle first so you will almost not even feel the IV go in. ONce the IV is placed you will get IV medication to put you into la la land before you go to sleep. I don't mess around with twilight for these operations. They are so delicate and require so much concentration and thought that I want my patients out. Not to say you can not have it done well with sedation; it just is not my choice. Once asleep the surgery takes 1-3 hrs depending on the complexity. Everyone has a very different pain threshold. Some barely have any pain and others are very sore. If you have an open or closed approach you will be sore and swollen. Swelling can last a good several months to one year. Most will be gone by 6 months. Scars will mature for one year. In the right hands with the right goals in mind it will all be worth it. I am glad I had mine. Never regretted it. I had very little pain. I know what recovery is like because I have done it. For me it was a cake walk. First day or two stinks but after that I was fine. If it is really what you want it will all be worth it.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Rhinoplasty anesthesia

During IV sedation anesthesia a small flexible IV (intravenous) needle is placed into one of the veins of the back of the hand. The skin can be numbed prior to placement of the IV.

Through this IV line, relaxing medication is given to make you fall sleep. The amount of medication given is adjusted to the specific needs of each person. After you are sleeping, some numbing medicine is also placed in the nose. 

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Anesthesia for Rhinoplasty

You basically have two choices for anesthesia for rhinoplasty and it really depends on what your surgeon offers.  At our office, we have both choices.  First, you can have "Twilight" or IV sedation.  For this, an IV in a vein in your arm.  The medications are then given through the IV to make you go to sleep, the help relax you and to relieve pain.  The other option is to have General Anesthesia.  In this type of anesthesia, you have an IV just like "Twilight" anesthesia, however, you are put into a deeper sleep and a tube is placed in your mouth to help you breathe.  You may also have medications given in the air (gas) that is circulated through the tube in your mouth.  These medications also help you sleep and relax.  Both types of anesthesia are safe and effective.  My suggestion would be to choose your surgeon based on their skill and reputation for the procedure and not by what type of anesthesia they use.


Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

How is General Anesthesia Given?

It sounds like you're very apprehensive about any needles or IV starts. An IV is required for general anesthesia both to deliver some of the medications as well as to provide you with fluids and any other medications that might be needed. The IV can be placed in the arm or in the hand and is not typically very painful. I give my patients an oral anxiety medication before their driver takes them to the surgery center. This usually takes the edge off and allows them to get through all of the pre-op preparation with minimal anxiety. I recommend that you talk to your plastic surgeon about your concerns. I am sure they will put you at ease.

I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Anesthesia for Rhinoplasty


I personally operate out of my own private fully accredited surgical center and work with a full time anesthesiologist. The anesthesia is provided by the anesthesiologist and typically you are brought to the operating room in the morning where you are placed onto the operating table. At that time the nurse and anesthesiologist will place the proper monitoring equipment on you. Then a small amount of xylocaine a numbing agent is injected into the sight the I.V. will be started. Typically either in the hand or the arm depending on the patients veins. Most patients do not even feel the I.V. started. At the proper time the anesthesiologist will give medications through the intravenous tube which allows the patient to be sleeping during their procedure. At the end of the procedure you are awoken and taken into the recovery room where you rest for usually an hour before being discharged to your caregiver. I hope this is helpful and know that the process does not hurt and most patients state they had an amazing rest. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.