At Centre for Surgery, your surgeon will discuss the full range of anaesthesia options available to you for your proposed procedure. You will be able to decide which anaesthesia option you would like to go with based on your needs and preferences.
Anaesthesia options include:
- Local anaesthesia
- Moderate sedation
- TIVA (involving general anaesthesia based techniques)
Highly precise and meticulously performed surgery requires anaesthesia techniques of the highest calibre. Our surgeons felt that traditional general anaesthesia (which often involves volatile gases and muscle blockers) did not meet our patients’ needs effectively. Surgeons at Centre for Surgery now perform all their procedures as a day case thanks to TIVA anaesthesia techniques. The procedure of abdominoplasty (tummy tuck), which traditionally requires a two to three night inpatient stay, is routinely performed as a day case at Centre for Surgery. The TIVA technique for cosmetic surgery is an evolutionary step forward from traditional general anaesthesia volatile gases which is the default method currently practised in the majority of operating theatres worldwide. Many surgeons believe that traditional general anaesthesia is unnecessary for cosmetic surgery procedures.
The goals of an anaesthetic technique specific for cosmetic surgery ideally should achieve the following three aims:
- Reduce or eliminate the pain associated with injection of local anaesthetic
- Reduce or eliminate patient apprehension
- Reduce or eliminate recall of the procedure
With Total Intravenous Anaesthesia or TIVA for short, sophisticated microprocessor-controlled delivery systems carefully control the amount of anaesthesia delivered to the patient. This is known as a target-controlled infusion (TCI) and represents an evolution in drug delivery techniques. For a TIVA method, the correct amount of drugs are also carefully determined with the use of a depth of anaesthesia monitor. This monitoring technology is known as the bispectral index (BIS). This means that precise doses of anaesthetic medication are delivered in the safest possible way. A key aspect of TIVA is the injection of local anaesthesia whilst you are asleep at the beginning of the procedure before the actual procedure begins. With the blocking of noxious stimuli to the brain, the release of the body’s stress hormones is minimised. This means you may wake up with very little if anything in the way of discomfort. A recent survey assessing postoperative pain in a sample of our former patients resulted in average pain scores of 2 out of 10. This compares with typically reported scores of 7-8 out of 10 for patients treated with traditional general anaesthesia. Traditional general anaesthesia can potentially result in too much medication being delivered meaning that the patient is at risk of respiratory and cardiovascular complications and may carry more risks compared with TIVA techniques.
Principles of an ideal sedation technique
- Preservation of a clear airway
- Preservation of spontaneous breathing
- Preservation of cardiovascular function
Benefits of TIVA
- Being unable to see, hear, feel or remember any part of the procedure is a key goal of an anaesthetist-led TIVA anaesthetic technique.
- Fast onset and fast offset with rapid clear headed emergence
- Use of less invasive airway devices
- You may wake up with a heightened sense of well-being due to the euphoric effects of the medications
- Minimal risk of postoperative nausea and vomiting, dizziness and drowsiness compared with traditional general anaesthesia
- Being able to have your surgery and go home on the same day
The elimination of many traditional tools of general anaesthesia means the following:
- Not using muscle relaxants minimises the risk of anaesthetic awareness
- Our anaesthetists may use the i-gel airway device which is less invasive and with less risk of sore throat. For facial surgery, anaesthetists prefer the flexible LMA device.
The future of cosmetic surgery anaesthesia
The delivery of a sedation technique personalised to your physiological requirements may also improve overall outcomes from your actual procedure in terms of reduced risk of bleeding or infection or other postoperative complications.
IV sedation techniques are more environmentally friendly compared with traditional general anaesthesia. No toxic anaesthetic gases are used which is much safer for preserving our natural environment.