What's the difference between Local and General Anesthesia?

Question

I'm getting Lipo of back, flanks and abdomen and I wanted to know what's the difference between local and general anesthesia? I would like to be awake for my surgery but if it's illegal or u safe, I won't ask for it?

David Hansen, MD · Answer

You should always get liposuctions under tumescent local with or without a little iv sedation. Never do general if you can help it. Under local you are awake, comfortable  and able to turn and stand up during the procedure so the doc can really fine tune you the best.  It is so much safer as well.

Donovan Rosas, MD · Answer

General anesthesia is defined as the state of induced amnesia (no memory), analgesia (no pain), muscle paralysis, and sedation medically induced for surgery. Patients will have some form of breathing tube placed in order to ventilate them as they are not breathing on their own (secondary to the muscle paralysis). General anesthesia is safe when provided by a board certified anesthesiologist in an certified operating facility.Other forms of anesthesia include local/sedation (MAC-monitored anesthesia care) and local. Sedation is a less intensive form of anesthesia which differs from general in that patients continue to breath independently through the procedure. Localalized patients remain awake but are given medication to numb the area being treated.Liposuction can safely performed under local, MAC sedation, or general. The decision is ultimately a function or patient and doctor choice (as well as what level of anesthesia can be provided at the facility in question.As always, discuss your concerns with a board certified plastic surgeon.

Brian Coan, MD, FACS · Answer

I would recommend you have an in person consultation with a plastic surgeon with these credentials: *Board Certified by the American Board of Plastic Surgery -- The gold star symbol*A member of the ASPS (American Society of Plastic Surgeons) -- The circle symbol*A member of the ASAPS (American Society of Aesthetic Plastic Surgeons) -- the Queen Nefertitti symbol with a Triangle  *On faculty at local plastic surgery teaching program -- in our office we are affiliated with both Duke and UNC schools of plastic surgery.    
Feel free to contact our office, it would be our pleasure to answer your questions in person. I hope this is helpful and wish you all the best in your journey.  My sincere best, Brian S. Coan, MD, FACS

Kevin Bounds, MD · Answer

General anesthesia involves alternating your state of consciousness and in doing so diminishes protective reflexes. This is why an anesthesiologist is employed for your comfort but more importantly your safety. Local anesthesia is an injection that allows the surgeon to perform the procedure in the area where the medicine was injected. Local anesthesia does not alter your level of consciousness or diminish your protective reflexes. Both can be employed safely, the primary difference is the requirement for an anesthesiologist when undergoing a general anesthetic.

Reza Momeni, MD, FACS · Answer

In general anesthesia, the patient is put completely to sleep.  A machine is used to deliver oxygen / breathing, and medications through the IV are used to induce a deep sleep for heavier procedure.  Local anesthesia involves injecting medications to numb the area where surgery is being done.  For small areas, local anesthesia can be used to accomplish surgery, but in large areas (e.g. tummy tuck, or breast reduction), it's not possible inject that much numbing medication safely.

Steven Wallach, MD · Answer

I have performed hundreds of liposuction cases under local but all patients get some oral meds to relax them. General is when the patient is fully asleep. Both ways are fine.  Good luck.

Salem Samra, MD, FACS · Answer

Procedures that are performed under local anesthesia alone involve placement of a "numbing medicine" such as lidocaine into the area where the operation is taking place. The surgeon typically injects the local anesthetic. The patient is wide awake and aware of the procedure, but no pain is experienced during the operation once the local anesthetic is in place. 
Procedures performed under general anesthesia typically involve an anesthesiologist. This is a specialized doctor who gives medications that lead to various levels of sedation so the patient is unaware of the procedure as it is happening. The maximum level of general anesthesia would involve the patient requiring intubation and connection to a ventilator to facilitate breathing.
The decision as to what is safest and effective is made between patient, surgeon, and anesthesiologist. Less invasive, shorter procedures often are performed under local anesthesia alone. More invasive, longer procedures often are performed under general anesthesia. That said, some patients need sedation to tolerate a less invasive, shorter procedure, and some patients have larger operations performed under local. Often a combination of local anesthesia and sedation is used. Again it requires careful consideration and planning to decide what is best for the patient.
Make sure you are seeing a board certified plastic surgeon who operates in a facility with board certified anesthesiologists. Hope that helps and good luck!

What's the difference between Local and General Anesthesia?

Answers (7)

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