Anesthesia For Plastic And Reconstructive Surgery

Plastic and reconstructive surgery has evolved over the last two decades, with advances in anesthesiology, pharmacology, perioperative medicine, and novel monitoring devices contributing significantly to these patients being able to recover and live safely. Patients with chronic pathologies such as diabetes, hypertension, heart disease, obesity, chronic obstructive pulmonary disease, congenital or trauma injuries, changes due to excessive weight loss and others, as well as patient-tourists who have traveled enormous distances are now able to receive cosmetic and reconstructive surgeries that in the past were rejected. The authors of this book also discuss various contemporary topics of anesthesia for plastic and reconstructive surgery that are especially interesting and controversial due to the latest developments on this subject.

One major by-product of the aging baby-boom generation has been a surging interest in cosmetic surgery. Out-patient cosmetic surgery clinics have sprouted up in droves all over the U.S., and the number of cosmetic procedures performed in 2005 increased by over 95% from the previous year. Although procedures like facelifts and abdominoplasties (the 'tummy-tuck') are considered minimally invasive, the anesthetic protocols and regimens here are often overly complex and unnecessarily toxic. Major complications involving anesthesia in this (and any other) surgical milieu can range from severe post-operative nausea and vomiting (PONV) to neuromuscular spasticity to mortality. The mortality spectrum of things may be rare, but there have been many cases in which perfectly healthy cosmetic surgery patients require emergency intervention due to a severe complication involving anesthesia. In recent years, many new anesthetic protocols have been developed to reduce the incidence of PONV and other complications, while ensuring that effective pain management and level of 'un-awareness' during surgery is always maintained.

The scope of use of local anesthetics in procedures in plastic surgery is covered in this issue of Clinics in Plastic Surgery. Discussion centers on plastic surgeons in private practice in ambulatory facilities and those scheduling time for OR in hospital facilities using local anesthetics while accommodating patient comfort and absence of side-effects post general anesthesia. Presented in this publication are the most common plastic surgeries that can be done under local anesthesia, each with a discussion of the optimal anesthetic, method of administration, and dosage. Video of the procedure or portion of the procedure, as applicable, accompanies the techniques along with a surgical case. The goal of this issue is to provide a concise reference for surgeons’ planning surgeries to review and perhaps adapt currently used methods with this latest information on local anesthetics. Surgical Technique is provided in detail with full analysis of Patient Selection and Planning, Complications and Post-procedure Care. Contents include Complications; Basic Science of Locals; Skin Grafts and Flaps; Peripheral Nerve; Foot Surgery; Breast Surgery; Liposuction; Hand Trauma; Oculoplastic Surgery; Ear Surgery; Hair Transplantation; among others.

The global obesity epidemic is growing in severity, affecting people of every age and costing healthcare providers millions of dollars every year. Every day, anesthesiologists are presented with obese and morbidly obese patients undergoing every type of surgical procedure; the management of these patients differs significantly from that of normal weight patients undergoing the same procedure. Anesthetic Management of the Obese Surgical Patient discusses these specific management issues within each surgical specialty area. Initial chapters describe pre-operative assessment and pharmacology; these are followed by detailed chapters on the anesthetic management of a wide variety of surgical procedures, from joint replacement to open heart surgery. Essential reading for anesthesiologists and nurse anesthetists worldwide, Anesthetic Management of the Obese Surgical Patient and its companion work by the same authors, Morbid Obesity: Peri-operative Management, enable both trainees and practised professionals to manage this complex patient group effectively.

Plastic and reconstructive surgery has evolved over the last two decades, with advances in anesthesiology, pharmacology, perioperative medicine, and novel monitoring devices contributing significantly to these patients being able to recover and live safely. Patients with chronic pathologies such as diabetes, hypertension, heart disease, obesity, chronic obstructive pulmonary disease, congenital or trauma injuries, changes due to excessive weight loss and others, as well as patient-tourists who have traveled enormous distances are now able to receive cosmetic and reconstructive surgeries that in the past were rejected. The authors of this book also discuss various contemporary topics of anesthesia for plastic and reconstructive surgery that are especially interesting and controversial due to the latest developments on this subject.

Patient safety is an overriding concern in all surgery and particularly in plastic surgery, where many of the procedures are elective, but information about patient safety has traditionally been scattered throughout the literature. Patient Safety in Plastic Surgery covers all of the essential patient safety topics in one valuable resource. Timely and practical, the book places special emphasis on clinical issues. It begins with the safety concerns most often identified by plastic surgeons, such as DVTs, surgical site infections, sleep apnea, and anesthesia safety. Beyond these obvious problems are major safety issues that often fall off the radar. These are critical to patient comfort and safety, but they do not always receive the attention they merit, such as hypothermia, nausea and vomiting, proper patient positioning, and screening and management of medical co-morbidities. Other important chapters focus on the identification and avoidance of patients who are poor psychological candidates for surgery and the legal aspects of safety. The book is edited by V. Leroy Young, a well-known plastic surgeon, and Richard Botney, a noted anesthesiologist. They offer readers the advantage of their combined experience along with that of a multidisciplinary group of experts on the different topics covered.

TUMESCENT TECHNIQUE is the definitive reference on all aspects of the tumescent technique of anesthesiology used in liposuction. Written by the inventor of the tumescent technique, this resource explains the pathophysiology, complications, pharmacology, and the different methods used to achieve great cosmetic results. Step-by-step instructions demonstrate how to perform this procedure on all areas of the body. Complications and postoperative care are also addressed. * Written by Dr. Klein, a leading expert in the field and the physician who invented and perfected the technique. * Provides step-by-step instructions for administering the local anesthesia with a practical, easy-to-follow approach. * Discusses tumescent liposuction techniques for each body region, addressing procedures, guidelines, and complications for each. * Covers complications and how to avoid them, preventing problems before they arise. * Provides detailed illustrations of techniques and before and after photographs to allow you to see expected results.