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IV Sedation with Local Anesthesia Proven Safe for Office-Based Plastic Surgery

ARLINGTON HEIGHTS, Ill. - Intravenous (IV) sedation with local anesthesia can be used safely for plastic surgery procedures in the office when administered by a certified registered nurse anesthetist (CRNA) and supervised by a board-certified plastic surgeon, reports a study in the January issue of Plastic and Reconstructive Surgery® (PRS), the official medical journal of the American Society of Plastic Surgeons (ASPS).

"IV sedation with local anesthesia has been criticized for not being as safe as general anesthesia (a deeper level of unconsciousness) in an office-based setting," said Peter Capizzi, MD, ASPS member and co-author of the study. "This study clearly demonstrates that CRNAs and plastic surgeons can provide patients with safe and effective anesthesia care in an office-based setting."

Physicians analyzed 3,615 consecutive patients who had office-based plastic surgery procedures with IV sedation and local anesthesia. Ninety-six percent of patients had cosmetic procedures and four percent had reconstructive procedures. More than 890 patients had multiple procedures during the same surgery. Less than one percent of the surgeries lasted for more than six hours. Liposuction was the procedure most frequently performed, followed by breast augmentation, eyelid surgery, and facelift. Not one patient in 4,778 consecutive procedures had major complications.

To ensure all procedures were performed safely, patients received a preoperative evaluation by the plastic surgeon and the CRNA at which time questions relating to the surgery and anesthesia were answered. Postoperative monitoring of the heart and blood pressure were mandatory. In addition, all patients were required to remain for a minimum of one hour in the recovery room with a designated registered nurse. The operating plastic surgeon was on the premises at all times during recovery.

"The demand for plastic surgery has risen to new heights in the past few years, with more than 5.8 million patients having cosmetic and reconstructive plastic surgery in an office-based setting in 2001," said Dr. Capizzi. "As plastic surgeons, the safety of our patients is our highest priority."

According to a PRS discussion article, this study confirms that CRNAs provide safe and competent care. According to a 2001 study conducted by the ASPS, 56.5 percent of plastic surgeons use CRNAs to administer anesthesia care in an office-based surgery setting some or all of the time. Physician anesthesiologists provide similar services. Forty-three percent of plastic surgeons exclusively use physician anesthesiologists to administer anesthesia care in an office-based surgery setting.

About ASPS

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

Contact ASPS

Media Relations | 847-228-9900 | media@plasticsurgery.org