Aesthetic surgery journal
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Running parallel with-and perhaps driven by-the huge increase in demand for cosmetic surgery, office-based anesthesia (OBA) is the fastest growing segment of anesthesia practice. Despite this, only 2% of anesthesiology residencies provide exposure to OBA, and many practicing anesthesiologists are not convinced that OBA techniques provide safe, reliable, and effective anesthesia care. ⋯ In experienced hands, OBA techniques deliver an anesthetic for office-based cosmetic surgery superior to the usual general anesthesia performed in hospitals and ambulatory surgical centers. These techniques are safe, do not require expensive equipment other than an infusion pump and vital signs monitor, avoid sore throats and nausea, provide postoperative analgesia, and are well received by patients and surgeons. OBA presents an opportunity for anesthesiologists and aesthetic surgeons to partner for greater patient satisfaction.
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Aesthetic surgery journal · Sep 2008
Quantitative effects of tumescent infiltration and bupivicaine injection in decreasing postoperative pain in submuscular breast augmentation.
In submuscular breast augmentation, the muscle is transected along its inferior and medial border to allow the implant to rest beneath the breast mound and supply adequate cleavage. This leads to significant pain in the postoperative period. ⋯ This is the first report to quantitatively show a pain reduction regimen that is effective in significantly decreasing postoperative pain and decreasing the use of narcotics in the recovery room. The authors conclude that its advantages are significant, and they advocate its use in all breast augmentations.
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Aesthetic surgery journal · Jul 2008
Randomized Controlled TrialCorrelation of complications of body contouring surgery with increasing body mass index.
There have been conflicting reports regarding the incidence of postoperative complications in body contouring procedures in obese and morbidly obese patients. Our subjective impression has been that the complication rate is significantly higher for these patients than it is for other weight groups. ⋯ This study demonstrates two points: (1) it confirms that there is a significant increase in the occurrence of complications among morbidly obese and severely morbidly obese patients undergoing a single body contouring procedure, and (2) it shows there is an increase in the occurrence of complications with worsening degree of obesity. The (post-weight loss) body mass index at the time of body contouring surgery is a predictor for postoperative complications.
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Aesthetic surgery journal · Jul 2008
Randomized Controlled TrialPregabalin has opioid-sparing effects following augmentation mammaplasty.
There has been a recent, growing concern regarding narcotic use in surgical patients. This issue, coupled with an ongoing desire to lessen postoperative discomfort, has prompted the search for alternative analgesic regimens. ⋯ Perioperative pregabalin administration in patients undergoing augmentation mammaplasty reduced postoperative narcotic use by 70%. There was also significantly less reported pain and a 46% reduction in nausea in the pregabalin-treated group. Pregabalin has few side effects, no drug interactions, and should be considered safe in an analgesic regimen.
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Aesthetic surgery journal · May 2008
Pain control in augmentation mammaplasty: safety and efficacy of indwelling catheters in 644 consecutive patients.
In an effort to give patients an additional effective form of analgesia, indwelling catheters for the instillation of a long-acting local anesthetic have been used to alleviate postoperative pain in patients undergoing augmentation mammaplasty. ⋯ A prospective study of 644 consecutive augmentation mammaplasty patients shows that indwelling catheters for the postoperative instillation of bupivacaine are both safe and effective in the management of postoperative pain. This gives the patient an additional form of analgesia, limited to the operative site, which is helpful in a multimodal pain management program. Both continuous flow and intermittent bolus self-administration systems are effective and their patient ratings are indistinguishable.