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Experience with More Than 5,000 Cases in Which Monitored Anesthesia Care Was Used for Liposuction Surgery
Authors:Dwight A Scarborough  Joel Bain Herron  Azim Khan  Emil Bisaccia
Institution:(1) Department of Dermatology, Columbia University, College of Physicians and Surgeons, 161 Ft. Washington Avenue, New York, NY 10032, USA;(2) Private Practice, Northeast Dermatology and Cosmetic Surgery Center, 1090 Beecher Crossing North, Suite C, Gahanna, OH 43230, USA
Abstract:Background Conscious sedation using monitored anesthesia care can provide a clinical spectrum from relaxation to moderate anesthesia. This middle ground between general anesthesia and ldquopurerdquo tumescent liposuction can help facilitate patient comfort and surgical proficiency during the procedure.Objective To describe a method of liposuction surgery with monitored anesthesia care in which a designated licensed and qualified individual is responsible for administration of supplemental intravenous conscious sedation as well as continuous monitoring of the patient.Methods Conscious sedation is induced with midazolam, and the patient is titrated to level II-V on the Ramsey sedation scale with propofol. The basic surgical technique is that of tumescent liposuction. However, the supplemental conscious sedation allows the tumescent fluid to be infiltrated at higher rates and fat extraction to be completed in a shorter period with minimal or no discomfort.Results In the authorsrsquo experience with more than 5,000 cases of liposuction surgery using this method, safety and efficacy have been proved. No patients have experienced significant adverse effects.Conclusion Tumescent liposuction surgery with monitored anesthesia care provides a middle ground between general anesthesia and purely tumescent liposuction.
Keywords:Surgery  Plastic  Anesthesia  Intravenous  Conscious sedation  Lipectomy
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