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Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(1):7-14.
Published online January 1, 2011.
Consideration on Application of Modified Monitored Anesthetic Care in Plastic Surgery.
Geon Cho, In Suck Suh, Young Ryong Choi, Mi Hwa Chung, Kyoung Seok Tak, Young Kyu Park, Jae Hyun Kim, Eung Yeol Ko, Ha Min Sung
1Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea. sismdps@chol.com
2Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
Abstract
PURPOSE
Many patients have fear for surgery owing to the injection of lidocaine and the possible pain in the course of the operation. To resolve such a problem the cases to do plastic surgery with monitored anesthetic care are increasing, in which something like sedatives is injected into vein without endotracheal intubation and under voluntary respiration, but the usage is now under the controversy. METHODS: There were 25 patients who had surgery with local anesthesia, and another 25 patients who had surgery with monitored anesthetic care which belongs to ASA class 1 and 2 from January to April, 2009. Their anesthesia records were collected and surveys were given before and after the surgery and the surgery staff recorded OAA/S during the surgery. The postoperative surveys included the awakening during the surgery, pain, anxiety, and the degree of patient's satisfaction through visual analogue scale to identify the difference between the two methods.
RESULTS
The OAA/S results according to time lapse show that it is possible to lead a fast effective sedation and recovery with monitored anesthetic care, and monitored anesthetic care enhances both surgeon's convenience level and patient's satisfaction level, and reduces awakening, pain, and anxiety, compared to local anesthesia.
CONCLUSION
The current paper shows about the plastic surgery, particularly the outpatient surgery, when monitored anesthetic care method is applied, it could gain a fast sedation and recovery or an effective sedation of patients. The method also has some affirmative effects in regard with surgeon's convenience and the patients' satisfaction degree and the reduction of their awakening, pain, and anxiety. With careful and adequate watch on the measures about vital signs like electrocardiogram, the degree of oxygen saturation, and blood pressure, it could clinically be very useful.
Keywords: Modified monitored anesthetic care; Propofol; Ketamine
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