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Facial aesthetic surgery safely performed under oral sedation, local anesthetics

Facial aesthetic surgical procedures performed under oral sedation combined with local anesthetics were safe and tolerated by patients, according to study results.

Researchers conducted a retrospective chart review on 199 patients (mean age, 49.8 years; 176 women) who underwent office-based plastic surgery procedure between July 2008 and July 2014.  The patients received oral sedation combined with local anesthesia.

Patients received minimal oral sedation that included a combination of diazepam, diphenhydramine, and hydrocodone/ acetaminophen or acetaminophen alone. There was a minimum of 30 minutes after receiving oral sedation before infiltration of local anesthesia to the surgical site was begun.

Age, gender, BMI, past medical history, social history, surgical history, allergies and medications were the patient demographic data collected and included in the review. American Society of Anesthesia (ASA) class, type of procedure, medications administered and major complications related to sedation were measured.

Patients underwent 283 facial aesthetic surgical procedures, with 195 patients in ASA class I and four patients in ASA class II. Procedures included 44 upper blepharoplasty procedures, five browlifts, 43 upper blepharoplasty-browpexy, 46 facelifts, 38 neck lifts/lower facelifts, 54 fat grafting, three tip rhinoplasties and 15 minor revision cases.

Average follow-up was 23.5 months. There were no major complications and no sedation issues during the study period, with all procedures completed under oral sedation. There were no cases converted to IV sedation, ended due to pain or discomfort, or requiring hospital transfer. All patients tolerated the procedures, with the average surgery length of 84 minutes.

“In healthy patients, office-based facial plastic procedures can be safely performed under a combination of oral sedation and local anesthetics,” the researchers concluded. “Patient selection and pretreatment counseling are critical in ensuring a satisfactory and safe experience.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.