Q. I want to have eye surgery but I’m scared of general anesthesia. Can I do my eye surgery without having general anesthesia?
A. The simple answer is yes. General anesthesia, when done with an appropriately trained board-certified anesthesiologist or a nurse anesthetist under the supervision of an anesthesiologist, is a safe procedure.
Generally, patients who undergo cosmetic procedures are healthy individuals with low-risk factors. If a patient has risk factors, then his or her procedure is normally done in a hospital.
The good news is that a great majority of my blepharoplasty operations are done with local anesthesia and sedation by an anesthesiologist. Because the eye area can be well anesthetized with local anesthesia, general anesthesia is rarely needed. Typically, a patient is given sedation via an IV and when the patient is not feeling anything, the local anesthesia is injected. Once the anesthesia is injected, the patient will have no pain and may be allowed to awaken.
During the surgery, the anesthesiologist may adjust the anesthesia levels so the patient is more asleep or less asleep. As a surgeon with more than 30 years experience of doing eye surgery, I can generally tell if a patient is comfortable. If I notice that the heart rate is going up or that the patient is uncomfortable, I will generally stop and ask the anesthesiologist to give more sedation so I can give more local anesthesia.
The drugs also give you amnesia so you will not have any recollection of the surgery. While you may not want general anesthesia for your procedure, it is possible to select that as an option. In my office, most patients like having sedation with a local anesthesia. If, however, a patient requires or needs general anesthesia, we are equipped as many other surgeons are to provide a general anesthesia for this procedure.
An LMA is used often for this particular type of patient. An LMA is a tube that sits just above the vocal chords and gives you a general anesthesia, rather than going through your vocal chords. The advantage of this procedure is that you enjoy the benefits of a general anesthesia without the risk of an intubation and waking up with coughing after the procedure is over.
This is a good topic to talk over with your surgeon prior to your day of surgery so you will be comfortable with whatever form of anesthesia you choose.
Dr. Carlos Wolf is a clinical assistant professor at the FIU Herbert Wertheim School of Medicine. He is a partner at www.miamiplasticsurgery.com He can be reached at firstname.lastname@example.org