Under what anesthesia is it better to do rhinoplasty. Rhinoplasty under local anesthesia: operation and drugs used for pain relief Rhinoplasty under local anesthesia

Rhinoplasty is one of the most popular facial surgery procedures. It is used when non-surgical prinoplasty (filler injection) is not suitable, for example, the patient wants to correct the shape or reduce the size of the nose, as well as to straighten a deviated nasal septum.

Today, uncomplicated rhinoplasty lasts no more than two to three hours. At the same time, it is absolutely not necessary to use general anesthesia in rhinoplasty, in some cases local anesthesia is also suitable (correction of the tip of the nose, correction of the shape of the nostrils, columella, etc.).

Types of rhinoplasty: incision outside and inside

The choice of anesthesia method during rhinoplasty surgery may partly depend on the type of operation itself. There are mainly two of them: open rhinoplasty and closed rhinoplasty.

The first option has now begun to gradually become obsolete, but in some difficult cases it is still used. Open rhinoplasty involves an external incision in the skin of the nasal septum, through which the rhinoplasty surgeon will remove excess parts of bones or cartilage.
The incision is made small, about 5 millimeters, but the scar from the dissection will be noticeable at first. Despite the fact that over time it will completely disappear, it is preferable to choose a method in which it will not be at all.

Open rhinoplasty most often involves general anesthesia, since the incision is made directly under the nose, and the patient does not need to see it with his own eyes.

The second way to change the nose- closed rhinoplasty. To date, surgeons mainly use it. With this type of plastic surgery, incisions are made inside the nose: one in each passage.
In this case, of course, there will be no scars and scars, at least noticeable from the outside. In addition, with closed plastic surgery, you can choose local anesthesia, you won’t see anything “terrible”.

Pain relief options

In total, during rhinoplasty, three types of anesthesia are possible:

habitual general anesthesia (mask, intravenously)
regional anesthesia (conduction, epidural, spinal)
local injection anesthesia (local with sedation).

General anesthesia

Of course, general anesthesia is the most effective and common type of anesthesia. The essence of this method of pain relief is that you are immersed in a deep sleep with medication, and you do not see, hear or feel anything during the entire procedure.

The general anesthesia given by anesthesiologists before the start of a rhinoplasty operation is much milder than with an abdominal operation. This is due to the fact that the surgical intervention is carried out outside and on a small area, which means that there are much fewer nerve endings that need to be “turned off”.
In addition, the directly operated surface will be anesthetized additionally, which means that fewer basic drugs are needed.

However, many are skeptical and even fearful of general anesthesia due to rumors about its harm to health, that you can wake up before the end of the operation, become drug addicted or even die. There is some truth in this.
The fact is that the danger / safety of anesthesia is directly dependent on the level of development of healthcare, the equipment of the medical institution with modern equipment, the availability of experienced anesthesiologists.
Therefore, the primary task is to find not only a good rhinoplast, but also a clinic that meets such requirements and guarantees a successful outcome of the surgical intervention.

Use of local anesthesia in rhinoplasty

There is an opinion that it is impossible to do rhinoplasty under local anesthesia. This is wrong. Now the method of local anesthesia is used quite widely. At the same time, you are not completely “knocked out”, as with general anesthesia, but only the nose and part of the face around it are cut off. Of course, you will not feel pain in this case, but you will see the surgical process from beginning to end.

In most cases, rhinoplasty under local anesthesia using anesthetics is used for simple or moderate operations.
When it is necessary to intervene in the nasal bone, the likelihood of using local anesthesia is drastically reduced. Local anesthesia involves small, local changes, including the tip of the nose.

Most often, anesthesiologists use solutions of lidocaine, marcaine and xylocaine for local anesthesia. They freeze the nerve endings, which, in turn, stop sending painful impulses, and the patient, accordingly, does not feel anything.
Recently, doctors have begun to switch to bupivacaine and naropin - about 16 times greater than novocaine in terms of strength and duration of freezing.

However, for the operating surgeon, the use of anesthesia may cause some discomfort, since the patient himself in this case will be an obstacle to the doctor's free manipulations.

Injections with a sedative effect

However, the process itself remains quite exhausting for the patient. Of course, not everyone can lie down for several hours, watching how a rhinosurgeon conjures over your nose or see your own blood.

Therefore, recently, doctors have begun to use local anesthesia with a sedative effect in rhinoplasty. In this case, a sedative is added to the anesthetic solution, the patient stops being nervous and may even fall asleep, but not deeply, but simply doze off.
But, I repeat about simple interventions, if there is a serious swotting of the nose, there can be no talk of any local anesthesia.

After operation

After completing all the manipulations with the nose, most patients want to calmly exhale and no longer think about pain, feeling unwell or complications. After general anesthesia, things can get tricky: patients often experience nausea, headaches, and weakness and lethargy.

When using local anesthesia, such consequences are minimized. At the end of rhinoplasty, patients almost immediately, as they say, are "vigorous and cheerful", since local anesthesia does not have an extensive effect on the body.

If you are seriously thinking about such a plastic surgery, you should first of all choose a good clinic.
If a doctor for rhinoplasty offers only local anesthesia: it is quite possible that he cares about your health, but most likely they do not have special equipment for applying general anesthesia or there is no anesthesiologist - resuscitator.
In this case, this clinic, to put it mildly, is not the most reliable. Although in many medical institutions, especially peripheral ones, injection anesthesia comes first and is more the rule than the exception.

However, remember that even though the last word remains with your doctor, the final decision is made only by you.

Rhinoplasty is one of the most popular plastic surgeries. Rhinoplasty is a serious surgical intervention, quite long in terms of execution time, since it involves the correction of pronounced aesthetic And reconstructive problems. At a preliminary consultation, the plastic surgeon and the patient discuss all aspects of the planned operation. The patient expresses expectations and requirements, the doctor coordinates them with the surgical intervention and informs the patient about the possibilities of rhinoplasty.

A lot of time is given by the doctor to convince his patient to give up the fear of the general anesthesia. Many patients have a lot of prejudices and fears about this, and someone perceives anesthesia simply as a dangerous factor, not knowing anything about it, while other patients believe that they know even more about anesthesia than a surgeon, and still fear it.

It is obvious that patients are not behind the decision on the choice of the method of surgical anesthesia, and the final word remains with anesthesiologist-resuscitator.

However, there are general rules that any plastic surgery establishments follow. First of all, the use of anesthesia during rhinoplasty should make excuses according to the method of surgical intervention, safety and health indications of the patient.

Many patients are very worried about the upcoming operation, but they are especially afraid of anesthesia. Some people even persuade the surgeon to perform the operation under local anesthesia. Numerous fears associated with anesthesia are largely associated with the past, when the operation was carried out without anesthesia or with the use of chloroform or ether.

People fear that anesthesia can cause irreversible situations. Many people have contraindications for its use, and in general, some people tend to think that the meaning of anesthesia is to make the patient unconscious without risking his life. After all, there were times when a certain amount of vodka for oral administration was used in the form of anesthesia. But it cannot be said that surgical manipulations after that turned out to be painless.

Before and after rhinoplasty

Advantages of anesthesia over modern anesthesia

Nowadays anesthetic anesthesia is a precisely verified and safe part of almost any surgical intervention, capable of making correct calculations of one's own capabilities in the fight against the patient's pain. One of the latest achievements of modern anesthesia is medical sleep, without harm to the patient's body, immersing him in unconscious state.

However, if the clinic of your choice lists rhinoplasty under local anesthesia among the listed advantages, this indicates such problems:

the clinic, most likely, does not have modern anesthetic equipment and equipment capable of monitoring the state of the body during the operation;
it may not have an experienced anesthesiologist-resuscitator capable of providing anesthesia.

Rhinoplasty under local anesthesia implies anesthesia small according to the volume of the tissue area and the skin of the patient. A person during the operation does not feel anything, but all medical manipulations reach his ears and eyes, especially rhinoplasty.

Among other things, the knock of a surgical instrument, the metal clamps used during the operation, and the skin flap that appeared after the incision is a huge stress. Here it becomes obvious advantage anesthesia before local anesthesia - an operation with preservation health And spiritual balance of the patient, avoiding any demonstration for the patient of the course of the surgical intervention that could cause shock to the person.

Remember that during rhinoplasty, general anesthesia should be a priority, and not local anesthesia, especially when it comes to an extensive amount of intervention by the surgeon. Of course, superficial problems can be solved with local anesthesia.

The use of anesthesia and additional anesthesia during the operation

The list of necessary equipment, which is necessary for a plastic surgery clinic, includes many items that can occupy a large room. An anesthesia machine requires a separate room, which is mandatory with all the equipment for each licensed plastic surgery clinics. Among other things, the clinic must have an anesthesiologist and his nurse. This is necessary to ensure the joint implementation of the correct filing anesthesia, because without these people, the surgical manipulations of the operating team are not able to give an adequate result.

During rhinoplasty, the nose, of course, not able to to spontaneous breathing. Therefore, the doctor introduces a special handset, which ensures the flow of air into the lungs and prevents the entry of mucous and blood secretions into the esophagus and lungs.

Due to the fact that the operation lasts from 2 to 4 hours (the time of the operation depends on the complexity of the situation and the volume of intervention), the constant presence of an anesthesiologist-resuscitator during the operation provides control over state patient. The oxygen content in the blood is continuously measured, the respiratory rate, blood pressure, body temperature are measured, and an electrocardiogram is taken.

Thus, it becomes clear that general anesthesia allows you to control the patient's condition, preventing any unforeseen problems during the intervention of the surgeon. To relieve pain in the area of surgical intervention, the doctor also introduces local anesthesia as an additional anesthetic. Obviously, anesthesia is not able to replace the effect of anesthesia, but it can perfectly accompany it during rhinoplasty.

Features of the postoperative period

After the patient wakes up, he is under the control of an anesthesiologist-resuscitator, who makes sure that the operation went well and that the patient is in good health.

Choosing the right institution for rhinoplasty

When deciding on rhinoplasty for aesthetic or reconstructive indications, remember that any intervention by a plastic surgeon, including rhinoplasty, is not an express procedure that takes several minutes, even though at least one of several plastic surgeons will try to assure you of this. If you are faced with the choice of a suitable institution for rhinoplasty, choose not the place where you are promised the elimination of any aesthetic defects under local anesthesia, but the one where the medical staff is aware of all painstaking and the severity of the interference and complies with absolutely all measures security.

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Each of us has its own characteristics of the structure of different parts of the body.

The tip of the nose is also different and may need correction.

Rhinoplasty of the tip of the nose is performed non-surgical and surgical methods, depending on what consequences and results the patient expects.

The choice of method and technique for performing manipulations depends on many factors and requires a highly qualified doctor.

How is rhinoplasty done?

Depending on the amount of necessary changes in the shape of the tip of the nose, its correction can be performed in different ways.

Minimally invasive procedures

They suggest the possibility of changing the outlines with the help of injections or correction of the tip of the nose with threads.

These procedures are almost painless, are performed quite quickly and allow you to correct minor defects, for example, slightly raise, reduce or smooth out a forked tip of the nose.

Rhinoplasty of the nose with the help of special threads provides quite ample opportunities. The tip of the nose is corrected under local anesthesia.

The threads are inserted into the thickness of the skin, fixed and tightened until the desired contour is obtained. All manipulations are performed through punctures, which are completely invisible after 2-3 days.

What to do for the desired result:

Abandon the “magic wand syndrome”, as rhinoplasty is not an instant solution, but a time-consuming operation that requires patience.
Choose a professional in the field of plastic surgery.
See photos before and after surgery.
Select a nose model using computer simulation.

Operational correction

Minimally invasive methods do not always allow you to achieve the desired result and correct significant defects.

In addition, their result is temporary, although it can last several years.

An operation to correct the tip of the nose may be necessary after injuries, when the direction of this area has changed, or with congenital structural features of the nose.

Often, something can be corrected or changed only with the help of rhinoplasty.

In some cases, it is necessary to remove excess tissues to give shape, then they are excised and sutured. In others, on the contrary, it is required to fill concave areas or hollows. Then, the patient's own tissues are most often used - correction of the tip of the nose with the help of an autochondrograft. They can be taken from cartilage located in other parts of the nose.

The operation lasts 2-3 hours. It can be performed under general or local anesthesia. This is decided on a case-by-case basis and depends on many factors. General anesthesia allows the surgeon to carry out a more extensive scope of intervention, and the patient to avoid unrest and discomfort during the operation.

Rhinoplasty under local anesthesia is good because the body suffers less from the effects of the anesthetic and it is possible to avoid side effects that may occur after general anesthesia.

Don't forget your anatomy!

Surgical correction of the tip of the nose can be performed by open and closed methods. The closed method involves making incisions inside the mucosa. Next, the doctor highlights the lower pterygoid cartilage and sutures in such a way as to form the desired shape of the tip of the nose.

With this method, there are no external sutures, so there is no risk that traces of the operation will remain. However, there are other problems that do not always allow you to achieve the desired result.

The possibilities of the surgeon when working with the closed method are limited, and the damage to the vessels is very difficult to control. As a result, the recovery period is lengthened, and the risk of developing hematomas is high.

The open tip rhinoplasty technique involves an incision in the bridge area, release of the pterygoid cartilage and removal of excess tissue. With the help of sutures, the desired shape of the tip of the nose is achieved. When working with the open method, the surgeon's errors are minimized.

The choice of method depends on the desired result and structural features of the tip of the nose, each time it is decided individually. For example, bifurcation correction can be performed with both methods.

With the open method, access and narrowing of the end part of the nose is made through an incision in the skin. When closed, additional tissues are introduced through the mucosa into the place of retraction. In this case, the results are very good.

If the tip of the nose is injured as a result of an injury, then the operation is performed by an open method. Often, a skin graft is required, which can be taken from the auricle. Nose injuries are by no means uncommon even in the average person, and not just in athletes.

What determines the choice of method

skin thickness,
nose dimensions,
The outline of his back
cartilage strength,
Angle between nose and upper lip.

Of course, the patient's opinion is taken into account, more precisely, his desire to have a certain result. However, one cannot be guided by this alone, and anatomical features must be taken into account, otherwise the operation can lead to completely different results.

Indications for surgery

The operation may be necessary for congenital anomalies in the structure of the tip of the nose, curvature resulting from injuries or illnesses.

Indications may be anatomical features that cause aesthetic or physical discomfort to the patient.

The tip of the nose may "look" to the side, hang down or be too upturned. All these defects and features can be corrected with rhinoplasty.

Contraindications

Like any surgical intervention, rhinoplasty has a number of limitations, which are due to the presence of certain diseases in the patient:

diabetes,
infection,
exacerbation of chronic processes,
oncology,
blood clotting disorder.

In addition, in women it is necessary to take into account the phase of the menstrual cycle. Pregnancy and the period of breastfeeding a child are periods when such operations are not performed.

Any person who dreams of having plastic surgery is interested in the issue of anesthesia during surgery.

Even less than a decade ago, many Russians were afraid of aesthetic medicine as such, since everyone heard terrible stories about anaphylactic shock, coma and other consequences of anesthesia. Unfortunately, we cannot refute such facts. In any country, there are unscrupulous surgeons who do not study the history in detail, and do not even ask the patient about his allergic reactions to medications. The negligence of a doctor, of course, can lead to unforeseen and irreversible consequences, so we recommend that you contact only competent specialists with extensive experience and developed skills.

Guess why minimally invasive methods of rejuvenation and correction of certain areas have become so popular today? The fundamental aspect, of course, is gentle anesthesia. However, a full-fledged operation, like, or, simply cannot be performed under local anesthesia and intravenous sedation. Let's look at the types of anesthesia and what "pitfalls" each of them implies.

Our presenter provides all types of aesthetic services, using only high-quality anesthetic preparations for this. Even after general anesthesia in our clinic, you will wake up alert and calm, you will not be haunted by dizziness, nausea and vomiting. We also guarantee you the absence of side effects after anesthesia and take responsibility for your condition during its operation.

What anesthesia is used for plastic surgery?

The very concept of "anesthesia" means the loss of any senses. However, this concept is too broad and needs to be detailed. What methods of anesthesia are used in plastic surgery?

General anesthesia.The classic method of anesthesia, which is used during a full-fledged invasive operation. This category includes, And , correction of the shape of the nose affecting the bone tissue, abdominoplasty, gluteoplasty, and other large-scale operations. In aesthetic surgery, intravenous combined anesthesia is more often used, but there are exceptions when inhalation technique is used. General anesthesia, or anesthesia, puts the patient into a state of deep sleep with complete loss of sensation. You will not feel any manipulations performed by the surgeon, nor pain. With the introduction of general anesthesia, doctors often resort to the additional use of muscle relaxants - drugs that relax the skeletal muscles. This creates comfortable conditions for the operation, without the use of a large amount of aggressive anesthetics and narcotic substances.

Local anesthesia.The essence of the use is to block nerve impulses in the local part of the fibrous tissue, on which the surgeon performs manipulations. The anesthetic can be applied in the form of an application, however, intradermal (injection) administration of an anesthetic drug is more often practiced. A kind of "cushion" is created, over the area of which the surgeon makes incisions and performs other actions related to the correction of a part of the body or face. Such anesthesia is appropriate for circular, upper and lower blepharoplasty, rhinoplasty, where only the cartilaginous and soft tissues of the nose are involved, short-scar and endoscopic lifting, and the introduction of threads. Local anesthesia is also used in all types of cosmetic services. At the request of the patient, anesthesia is used during contouring, mesotherapy, biorevitalization, , laser resurfacing. In addition to the application and injection method of administering the drug, local anesthesia also includes various ointments and gels of local action.
intravenous sedation.The effect of this anesthetic procedure is similar to premedication on the eve of a full-scale surgical intervention. You will be immersed in a light superficial sleep, your condition will be psychologically comfortable, strong fear and excitement before the operation will disappear. This type of anesthesia is often combined with local anesthesia. Also, intravenous sedation is always used together with regional (epidural) anesthesia. The latter, however, is rarely used in aesthetic medicine. Intravenous sedation does not block pain, its main task is to eliminate anxiety and fear, to relax the patient, to put him into a healthy, shallow sleep. The patient's actions are somewhat inhibited, but the behavior is completely adequate. This type of anesthesia is often used in combination with local anesthesia for septorhinoplasty, blepharoplasty, and minimally invasive types of lifting.

General anesthesia: terrible myths and possible consequences

Modern anesthetics used in the field of aesthetic medicine have low toxicity, so they rarely cause complications and ailments after surgery. Our clinic uses only the most modern high-quality drugs that will not cause problems for your health.

What are the consequences of general anesthesia?

No matter how gentle the drugs are, general anesthesia is a strong stress for your body. Therefore, we recommend that you give preference to local anesthesia and intravenous sedation, if possible.

Anaphylactic shock is the main "horror story" of all opponents of plastic surgery. In fact, the risk of such a syndrome does exist, and it depends more on the patient than on the doctor. We strongly recommend that you articulate all of your history of anaphylactic and allergic reactions to medications when you first talk to the anesthetist in order to avoid such consequences.

Coma. It is extremely rare in plastic surgery and is more often associated with the patient's severe condition during an emergency operation. If you do not have serious health problems, as well as absolute contraindications to plastic surgery, you are not at risk of this complication. A competent surgeon will always play it safe and examine in detail the state of your body before performing a "voluntary" operation. In addition, any modern clinic is equipped with resuscitation and all the necessary means to quickly bring the patient to a healthy state in any emergency.

. "What if I wake up?" A question that torments most future patients of plastic surgery clinics. The fear of waking up during an operation often wins over common sense, as a result of which the patient delays going to the doctor even with the most terrible defects. We prefer to dispel this myth: modern anesthetics literally guarantee the action all the time allotted for the operation. In addition, the anesthesiologist's task here is not complicated by the patient's difficult condition, as can happen with conventional surgery. Therefore, even if the doctor needs additional time to correct your defects, our anesthesiologist can "prolong" your sleep without compromising your health.

. "What if I don't sleep?" During the conversation with the anesthetist and study of your tests, you will be selected the best option of anesthesia, which is guaranteed to affect your consciousness. If for some reason this does not happen, the doctor will cancel the operation.

What anesthesia is used during operations:

Anesthesia for lip augmentation

If you want to increase the volume of the lips using hyaluronic acid, increase the cheekbones or chin

The doctor in this case will apply anesthesia with applications of a cream containing lidocaine. The cream is applied to the face, and after 30-40 minutes of waiting, the patient feels numbness in the facial area. Such a freeze indicates the disappearance of pain sensitivity for 20 minutes.

If the patient has a low threshold of pain sensitivity, the doctor uses dental or conduction anesthesia. With the help of it, there is absolutely no sensation of pain during the procedure. A not too pleasant nuance is that the face remains numb for about 2 hours. During freezing, do not eat or drink. Alas, not every doctor knows this technique of performing anesthesia, since it requires a deep knowledge of the anatomical features of the face.

Anesthesia for laser resurfacing of the face (medium or deep)

Laser resurfacing of the face is carried out using application anesthesia in combination with a small intravenous sedation. The laser is usually used under local anesthesia.

However, sometimes, for example, in the presence of rough cicatricial formations or irregularities on the skin of the face - a condition that manifests itself after acne, the so-called post-acne, the skin needs a deeper study. And here some painful sensations are possible. For this reason, in addition to local anesthesia, drugs are administered intravenously, due to which pain sensitivity disappears for 15-20 minutes. This effect is different from general anesthesia!

Laser resurfacing is performed with surface anesthesia. The patient is guaranteed a feeling of peace and relaxation without pain. The appointment of this type of anesthesia requires testing. If the results are available, the anesthesiologist conducts a consultation. As a rule, it takes only one visit to the clinic.

Anesthesia for scar eraser or removal of benign tumor formations - lipomas, atheromas and others

The operation is performed under local anesthesia. The patient transfers the only pain sensation - during the injection directly into the operated area. After that, there will be no more pain, because the anesthetic injection will begin to work.

Anesthesia for blepharoplasty or S-lift facelift

TIVA anesthesia is considered a powerful anesthetic achievement of our time. Patients are no longer tormented by nausea, vomiting, or feeling dizzy at the end of the operation. They fall asleep and come to their senses, already being in the ward of the clinic. Patients are not even aware of the spectacle of the walls of the operating room and its first-class equipment.

TIVA anesthesia is an absolute departure from the classic “tube inserted into the mouth”. With the help of a special apparatus, an anesthetic drug is automatically administered intravenously. Its amount is strictly dosed, the dosage is calculated taking into account the patient's body weight. Doctors choose TIVA anesthesia for patients with a history of arterial hypertension. This method of anesthesia is good because during the operation the patient's pressure is controlled by the doctor.

There are times when the anesthesiologist considers general anesthesia to be appropriate. As a rule, such a decision is made by the doctor if the operation lasts longer than 2.5 hours. At the same time, there is no reason to worry: general anesthesia - anesthesia - is carried out only using the most modern drugs that are guaranteed to be safe.

There are myths saying that after operations performed under general anesthesia, people's memory deteriorates significantly, hair falls out, and other health problems appear. However, these are nothing more than legends. And the combined multicomponent anesthesia in the clinic of Dr. Oleg Banizh has nothing to do with these stories.

Anesthesia for rhinoplasty

All types of surgical intervention in the nasopharyngeal region are performed using general anesthesia with endotracheal support. This type of anesthesia is simply necessary to ensure the safety of the operation. It is also a moment that gives the doctor confidence that he will perform the procedure at a high level.

Anesthesia for mammoplasty or abdominoplasty:

Such operations are not complete without general anesthesia, called endotracheal anesthesia. If the mammary gland is operated on or an operation is performed in the body area, the patient needs a deep state of analgesia - pain relief. Here the surgeon cannot apply local anesthetic in a large volume. Therefore, with the help of general anesthesia, it is possible to make sure that the patient does not have any discomfort associated with the operation - neither before nor after it. Upon completion of these operations, the specialists of the clinic of Dr. Oleg Baniz vigilantly monitor the patient for 48 hours.

Anesthesia for liposuction (laser liposuction)

In this case, the clinic specialists use spinal anesthesia in combination with intravenous sedation. With the help of this method of anesthesia, liposuction is performed in the abdomen, thighs, the area above the knees, the “breeches” are removed, the volume of the buttocks or the lumbar region is reduced.

Patients often have a question: do injections into the spinal cord? We hasten to reassure you - no injections in the spinal cord are required for this. There is no spinal cord in the area in which spinal anesthesia is performed. It contains only nerve endings responsible for pain.

With the help of this type of anesthesia, the conduction of nerve impulses to the area in which liposuction is performed is blocked for approximately no longer than 4 hours. By the time the patient wakes up, the return of all sensations is guaranteed. Perhaps the only caveat here is that after the operation is completed, the patient may experience a feeling of numb limbs within an hour or two. This operation does not require the use of general anesthesia.

For liposuction of the chin, TIVA anesthesia is used.

So, we have listed a whole list of methods that are successfully used in the clinic of Dr. Oleg Banizh to help the patient comfortably endure an operation or procedure. The clinic has everything to ensure the safety of the patient, and what could be more important? Intensive care unit, any emergency response facilities that you may need - we are 100% prepared!

The issue of anesthetic care worries many patients almost more than rhinoplasty itself. Patients ask plastic surgeons a lot of questions. Can a rhinoplasty be done under local anesthesia? What to do if there are any chronic diseases of the cardiovascular or respiratory system, such as arterial hypertension, coronary disease or bronchial asthma? Are there complications associated with anesthesia?

The proposed publication will provide answers to the main questions. You will learn how anesthetic management is carried out, how to avoid unpleasant symptoms after general anesthesia.

Is local anesthesia used for rhinoplasty?

In most clinics in Moscow (and any other city), you will get a definite answer: in theory, rhinoplasty can be done under local anesthesia, but in practice, general anesthesia is used in 99.9% of cases, that is, anesthesia. It should be noted that the term "local anesthesia" is incorrect, although it is sometimes used by non-specialists. The terms "local" or "general" apply to anesthesia. As for anesthesia, this is a synonym for the term general anesthesia, and it cannot be local in any way.

Local anesthesia can be infiltration, application, conduction or regional. The type of anesthesia is determined by the method of administration of the anesthetic. For example, during infiltration anesthesia, the tissues on which manipulations will be performed are impregnated with it. With conduction anesthesia, the transmission of a nerve impulse along a certain nerve, which is its conductor, is blocked. Infiltration and conduction anesthesia are actively used in dental practice.

With application anesthesia, an anesthetic is applied to the surface of the skin or mucous membrane. A similar method is often used in cosmetology before injection or hardware procedures, which are accompanied by pain. It should be noted that even with such simple manipulations, the application method does not provide complete anesthesia, and therefore its use in rhinoplasty is out of the question.

Regional anesthesia is often used in obstetrics for labor pain relief. For many women, epidural anesthesia, which is a regional variant, has helped them get through difficult labor without excruciating pain. In rhinoplasty, regional anesthesia, that is, anesthesia of a large anatomical zone, is not used.

As you can see, conduction and infiltration remain among the options for local anesthesia. Given the successful use of these in dental practice, it is hardly worth fearing the occurrence of pain. In dentistry, manipulations on bone tissue are performed, which should be accompanied by excruciating hellish pain, but the patient does not feel anything. This once again proves the effectiveness and reliability (sufficient duration of pain relief) of these types of anesthesia.

But what about in practice? Plastic surgeons agree that rhinoplasty should only be performed under general anesthesia. In theory, you can operate under local anesthesia if you have a simple operation on the cartilaginous elements of the wings and the tip of the nose. However, even here it is better to use anesthesia.

Why anesthesia is better?

Pain is not the only problem with surgery. We must not forget about the duration of the operation and the emotional state of the patient. It is extremely difficult for a person to endure one and a half or two hours, which will be rhinoplasty. During these two hours, you must lie absolutely still. The slightest careless movement can negate the efforts of a plastic surgeon. All this time, the patient hears the ringing of surgical instruments and feels manipulations on the tissues of the nose, since proprioceptive sensitivity is partially preserved.

Rhinoplasty under local anesthesia is a much more emotionally and psychologically difficult, tedious and exhausting process than many people can imagine. Even if such an anesthetic option is theoretically possible, the surgeon will recommend general anesthesia, and he will be absolutely right.

In practice, local anesthesia is operated only in clinics that either do not have a full-fledged operating unit with an anesthesia and respiratory apparatus, or do not have a qualified anesthesiologist-resuscitator on staff. If you were offered local anesthesia, citing the “simplicity” of the operation, it is better to get a consultation at another clinic. This will be the right decision.

General anesthesia for rhinoplasty

Narcosis in rhinoplasty also has certain features. As a rule, combined general anesthesia is used, including intravenous and endotracheal delivery of the drug. One drug enters the blood through a catheter, which is placed in a vein, the second - in the form of a gaseous mixture through the endotracheal tube.

This type of anesthetic aid has maximum reliability and safety. What does reliability mean in relation to anesthesia? This means that the anesthesiologist-resuscitator fully controls the depth and duration of the oppression of consciousness. The option that the patient suddenly “wakes up” in the middle of the operation is completely excluded. The person will return to consciousness immediately after returning from the operating unit to the ward, and not a minute earlier.

About security. Anesthetic risks are present, but they are minimal. The patient is assigned a diagnostic examination at the stage of preoperative preparation. He takes a lot of tests, undergoes an ECG, and, if necessary, consults with narrow specialists. The operating team receives objective information about the state of health of the cardiovascular, central nervous and respiratory systems. If the diagnosis revealed deviations from the norm that increase the degree of anesthetic risk, rhinoplasty is not performed at all or is postponed until the identified violations are completely corrected.

If there are no obvious or hidden diseases, anesthetic risks are minimal. During anesthesia, the function of the respiratory and cardiovascular systems is under the complete control of the anesthesiologist. The doctor closely monitors hemodynamic parameters. Breathing is provided by the anesthetic-respiratory apparatus (a person cannot breathe on his own, since narcotic substances have a muscle relaxant effect). Thus, the patient's breathing is also under the control of the medical team.

Recovery from anesthesia: how to reduce symptoms?

To put it bluntly, nothing threatens the life and health of the patient during rhinoplasty. In fact, any freeway ride is more dangerous than a rhinoplasty, which is performed under anesthesia by an experienced and qualified medical team. The only problem may be the exit from anesthesia, which is accompanied by unpleasant symptoms.

After recovery from anesthesia, the patient may experience headache, dizziness, nausea, confusion, and some disorientation. The severity of symptoms depends on which drug was used for anesthesia, whether the dose was chosen correctly. An experienced anesthesiologist will make sure that the recovery from anesthesia is “clean” and easy; for him, this is a matter of honor and an indicator of professional excellence.

As for the patient, he can take certain measures in advance. On the eve of the operation, you can not drink alcohol, drugs with sleeping pills or a strong sedative effect. The exception is drugs that are prescribed by a doctor. Otherwise, sedative medications can increase the effect of narcotic drugs. This is not dangerous to health, but getting out of anesthesia can be more difficult.

Rhinoplasty is best done under general combined anesthesia. Anesthesia does not threaten the life and health of the patient, and with proper preparation for the operation, the exit from it will pass with a minimum number of unpleasant symptoms.