Rhinoplasty under twilight sedation
Twilight anesthesia for rhinoplasty
There are many factors in deciding which anesthesia is best for each patient and for each procedure. Generally speaking, both twilight and general anesthesia are equally safe for rhinoplasty. This has been proven by multiple non randomized studies. I believe all things being equal, the patient should also have a choice of which anesthetic they prefer. (Robert M. Jensen, MD, Medford Plastic Surgeon)
Rhinoplasty Anesthesia: LMA General
Virtually all of my Rhinoplasty patients have general anesthesia using LMA. This helps protect the airway and maintain a deep enough plane of anesthesia so that the patient is comfortable.
This has been my preference for the last 9 years and has worked well for my patients. However IV sedation in the right hands is very safe for Rhinoplasty. (Stephen Prendiville, MD, Fort Myers Facial Plastic Surgeon)
General anesthesia is safer for Rhinoplasty
I would reguest general anesthesia if I was going to have rhinoplasty. There are many great surgeon who do rhinoplsty under twilight sedation and have great results,but the main concern is the bleeding and loss of air way. This is even more important in a patient with anxiety.
The anxiety will cause higher blood pressure and this will lead to higher risk of bleeding and airway loss. Please find a surgeon that you trust and if he feels that he can give you good result, then trust him to choose the anesthesia. (Kamran Khoobehi, MD, New Orleans Plastic Surgeon)
Twilight vs. General Anesthesia for Rhinoplasty
Anesthesia is one of the main causes of concern and anxiety for many patients considering rhinoplasty. These days, there is not a huge difference between general anesthesia (being completely asleep) and twilight anesthesia (deep sedation).
Under twilight anesthesia, patients are breathing on their own and the anesthesiologist is monitoring the amount of medication given to keep them unaware and comfortable. Under general anesthesia, slightly more of the same medications are given to make patients completely unaware, and breathing is assisted with some sort of breathing tube.
Twilight anesthesia can be very effective and some surgeon/anesthesiologist teams prefer it. In my experience, however, most patients who tend towards being a little anxious prefer general anesthesia. That way, you can be assured that you should not have any awareness of the proceedings. In the hands of a good anesthesiologist, either approach should be equally safe. Talk to your surgeon regarding your concerns. (Jason Litner, MD, Beverly Hills Facial Plastic Surgeon)
Twilight Sedation vs. Deep Sedation
There are different depths of sedation. If you have deep sedation, administered by a well trained anesthetist or anesthesiologist, you will not feel or remember anything.
The key is find an anesthetist that is comfortable and experienced performing this type of anesthesia. If the anesthetist is not experienced with this type of anesthesia, you may experience a roller coaster ride of waking up and going to sleep.
In that case, You would prefer the general anesthetic. I don’t think that any kind of light sedation will do. (Oleh Slupchynskyj, MD, FACS, New York Facial Plastic Surgeon)
Sedation for nasal surgery
I have been doing this for over 35 years using mostly sedation or “twilight”. For me, it is the comfort of using the same anesthesiologists for years and our working together to make sure the patients have a comfortable and safe surgery. Make sure the doctor is doing this in a Certified office or facility. (William B. Rosenblatt, MD, New York Plastic Surgeon)
Twilight anesthesia is safe for rhinoplasty but I prefer general anesthesia
I have performed over 1000 nasal procedures under sedation anesthesia. It is safe for most patients. However sometimes patents may get “antsy” and require more sedation and some may be very sensitive to the sedation. In that case a more secure airway is needed. I now avoid that condition by using LMA for general anesthesia. This device is much less irritating to the airway than the old intubation method. So the amount of anesthesia drugs used is only slightly more than sedation.
If you ask any anesthesiologist which method they prefer when giving anesthesia for a rhinoplasty the vast majority will choose general anesthesia. (Steven J. Pearlman, MD, New York Facial Plastic Surgeon)
General anesthesia is safer than twilight
Twilight sedation is not as safe as general anesthesia for rhinoplasty surgery. The nose is a difficult structure to completely numb with a local anesthetic. With twilight anesthesia there is no control of the airway and if extensive bleeding occurs this would pass through the vocal cords, into the trachea and compromise the airway. In twilight anesthesia you are partially awake and conscious while the surgery is going on. If nasal bone osteotomies (breaking nasal bones) have to be performed you are likely to remember this under twilight, which is why this type of anesthesia is not recommended.
You should know who is administering your anesthesia; I would recommend a board certified physician anesthesiologist. (William Portuese, MD, Seattle Facial Plastic Surgeon)
Rhinoplasty and different types of anesthesia
Rhinoplasty can be safely performed under general or twilight anesthesia. The advantages of twilight anesthesia is faster recovery but the big downside is possible recollection of the surgery and having some knowledge of what’s going on including possibly pain or noises associated with bone scraping, etc. If you are anxious about it, general anesthesia is an excellent safe way to proceed especially if an anesthesiologist is involved. I prefer for my patients who are anxious to have it done that way so that it is a more pleasant experience otherwise it is really patient preference. (Scott Trimas, MD, Jacksonville Facial Plastic Surgeon)
Is twilight anesthesia safe for Rhinoplasty?
Depending upon your anesthesiologist and surgeon, yes, twilight anesthesia for rhinoplasty is safe. Sounds like you should have a deeper anesthesia unless you will be able to tolerate hearing a little “tap tap tap” during your osteotomies.
For years we performed our rhinoplasties under “twilight”, but with the advent of safer anesthetic techniques, we now perform almost all of our rhinoplasties under a light general anesthesia (IV diprovan with an LMA tube). (Michael A. Persky, MD, Encino Facial Plastic Surgeon)