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Narcosis

!Consultation with anesthesiologist is mandatory before surgical operation!

Narcosis (general narcosis, "drug induced sleep" or general anesthesia) -  this is a sleep state caused by the administration of medications with loss of consciousness and pain sensitivity.

I periodically hear at consultations that patients are afraid not so much of the plastic surgery itself, but rather of narcosis. In the old days, this fear was indeed not unfounded. But in our time, the situation has changed: modern drugs work much more gently. Now anesthesiologists prepare a "cocktail" of several drugs, and the amount of each is strictly dosed and fully controlled.

An experienced, qualified anesthesiologist-resuscitator, high-tech narcosis and respiratory equipment and the use of modern, safe drugs guarantee high-quality narcosis, minimization of risks and a comfortable condition of the patient after general anesthesia.

Safe types of general anesthesia

We use advanced types of narcosis: gas narcosis or intravenous narcosis during plastic surgeries that require general anesthesia.

Gas narcosis

We use a modern inhalation anesthetic Sevoran®, which is manufactured in the UK, for gas narcosis. The main ingredient of the drug – sevoflurane has an anesthetic effect.

This type of "medication induced sleep" is carried out exclusively with artificial ventilation of lungs, , when the device breathes for the patient. An intubation tube is inserted through the patient's mouth into the trachea, which creates a reliable airtight connection between the patient's lungs and the ventilator. Oxygen and vapors of a sleeping drug – an inhalation anesthetic are supplied with its help. The patient does not know, does not remember and does not feel in any way how this happens, since he or she is deeply asleep and is under the influence of painkillers at this moment . Weaning from the device occurs in the same way. Therefore, most patients do not remember that they had a tube in their mouth at all..

Gas narcosis with Sevoran has virtually no effect on haemodynamics, is completely manageable and provides for continuous monitoring of the depth of general anesthesia. Sevoflurane does not change in the body with formation of harmful substances and is absolutely non-toxic. The patient quickly falls asleep under the influence of the drug, and he or she wakes up almost immediately after stopping of its supply.

Contraindications: hypersensitivity to sevoflurane; genetic predisposition to the development of malignant hyperthermia.

Intravenous anesthesia

A modern hypnotic drug Propofol Lipuro (produced in Germany). is injected intravenously comprehensively with analgesic drugs.

Propofol Lipuro – is a medical drug of new generation. This is a hypnotic drug which is used to maintain a patient in the condition of general anesthesia and is administered intravenously. Propofol is not allergenic and causes no side effects. This is one of the best options of narcosis used worldwide.

General anesthesia takes place as early as in 1-2 minutes after injection of the drug.

This medical drug is easily manageable: continuous supply of the drug takes place with the help of special equipment for maintenance of general anesthesia. Patient wakes up in 5 minutes after supply of the medicine is stopped and quickly returns to consciousness. Propofol quickly exerts from the organism.

Contraindications: intolerance to egg white and soy products

Table of comparison of types of narcosis

  Gas narcosis with Sevoran Intraven. narcosis with Propofol
The need for intubation (artificial lung ventilation)  necessary  not necessary
Sleep onset time 20-30 sec 30-40 sec
Drug manageability high high
Effect on haemodynamics absent absent
Restoration of consciousness and physical and motor functions fast fast
Cumulation (accumulation in the body) absent absent
Nausea, dizziness after coming out of narcosis rarely rarely
Time of moving out of anesthesia after stopping the drug supply 15-20 min 5-7 min
Clearance from the body fast fast
Risk of toxicity to the patient's organs low low

What does an anesthesiologist-resuscitator do?

The main task of the anesthesiologist-resuscitator is to ensure that the plastic surgery is painless and safe for the patient.

How does a consultation with an anesthesiologist take place

  • 3-4 days before the plastic surgery, the results of the patient's tests and examinations are transferred to the anesthesiologist, which he carefully studies (List of preoperative tests)

  • The initial consultation is a detailed conversation about the condition and peculiarities of the patient's health, chronic diseases, finding out complaints, and drawing up a medical history. Based on these data, the composition and dosage of painkillers is selected.

  • The doctor tells how to properly prepare for the operation and gives an instructions (memo) to the patient

The anesthesiologist-resuscitator accompanies the patient on the day of the operation:

  • before the operation, he or she performs an examination and premedication (administration of drugs that facilitate further anesthesia)

  • after placing the patient on the operating table, the anesthesiologist performs anesthesia and constantly monitors readings of the devices and the patient's well-being

  • after the end of the plastic surgery, the anesthesiologist monitors the patient's recovery from narcosis and his or her condition. After his approval, the patient is transferred to the ward under supervision of medical staff

Frequently asked questions about narcosis

Will not I wake up during the operation?

No, this is excluded. In addition to individual calculation of the dosage of drugs by the doctor, also there is a constant monitoring of depth of anesthesia, well-being and vital indicators of the patient both with the help of modern equipment and by the anesthesiologist during narcosis . The operated person is under full control.

Why do plastic surgeons not recommend performing operations under local anesthesia?

  1. First, with local anesthesia, one needs to be prepared that introduction of the anesthetic drug itself is a painful procedure.
  2. Secondly, although during the operation under local anesthesia, like under general anesthesia the patient does not feel pain, yet he or she is in a state of discomfort and is nervous. If a person is nervous, his blood pressure jumps sharply, which can lead to extra blood loss, hematomas and formation of a rough scar.
  3. Thirdly, local anesthesia does not the patients to completely relax the tissues and create all the conditions for fine surgical work with them

In our times, plastic surgery is performed under local anesthesia due to economy, or in the absence of capacity to conduct a high-quality general anesthesia.

Review about anesthesia

Feedback of my patient about narcosis with Propofol @murzilkatube

  • Отзыв о Пропофоле Липуро часть 1
  • Отзыв о Пропофоле Липуро часть 2

     

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