My plastic surgeon said he will only give me valium and no IV sedation. Is this normal?

Question

I have a large nodular basal cell carcinoma in my nose, I need to get a moh's procedure then go to a plastic surgeon for a flap repair and he won't give me IV sedation or general, just Lidocaine

Jonathan Landon, MD · Answer

Thank you for your question. This question comes up often in my practice, thus answering it will be helpful to both you and many others. 
Many Plastic & Reconstructive Surgeons, including myself, have significant training in the art of nerve blocks. Injecting a few CCs of Lidocaine in key areas, depending on what needs to be anesthetized for surgery, can result in a completely pain-free experience without the need for sedation or general anesthesia (along with the increased complications associated with these). 
In my practice, I routinely, almost on a daily basis, perform advanced reconstructive procedures following the resection of skin cancers solely under nerve block without the use of any IV sedation and CERTAINLY WITHOUT the need for general anesthesia. I cannot recall the last time a patient complained of any discomfort whatsoever during the procedure. Furthermore, with appropriative post-operative pain management, the most ANY patient reports may be some mild soreness the evening of the procedure, followed by absolutely no discomfort thereafter.
Jonathan Landon, MDChief of Plastic & Reconstructive SurgerySouth Shore Plastic & Reconstructive Surgery

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question. I can understand your anxiety about the procedure, but the Mohs surgeons in my practice have over 20 years of experience and do not use IV or general sedation for even the biggest cases.  People tend to do very well with an antianxiety medication if needed, and expertly placed injected buffered Lidocaine.  Please discuss your concerns with your Mohs surgeons and they will help to relieve your fears.  Good luck with the procedure!

My plastic surgeon said he will only give me valium and no IV sedation. Is this normal?

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My plastic surgeon said he will only give me valium and no IV sedation. Is this normal?

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