Twilight Anesthesia

[killtheboobs]

Some of the surgeons do not use a Anesthesiologists for Twilight . Is it ok for a gynecomastia surgeon that the surgeon administers anesthesia. Some use Nurses who are qualified in anesthesia but I am not sure if they are capable/allowed to administer Twilight anesthesia.

Is this safe or risky? What kind of accreditation should the surgical facility have. Or is a Hospital a better place for surgery as it has all options available at one place for any issues that can come up.

On an average how much will a hospital charge for 1 night stay post surgery for accomodation?

Look forward to some comments from Senior Doctors on board

[Litlriki]

This was the technique I used up until 2000, when I left my practice at the University of Massachusetts Medical Center.  A nurse worked with me to administer the anesthetic medications, and the patients did very well.  I would continue to use this approach, but at the facility where I work, that's not an option.  There is an appropriate level of certification (AAAASF or Quad-A Certification) which would be reasonable to look for for some reassurance. 

Rick Silverman

[DrPensler]

There are a variety of options for sedation and anesthesia.I would recommend you be certain that the surgeon is a member of the American Society of Plastic Surgeons and /or  the American Society of Aesthetic Plastic Surgery. Members of the aforementioned societies only operate in accredited facilities.The use of accredited facilities is designed to enhance patient safety.

[Dr. Elliot Jacobs]

There are several acceptable methods of anesthesia for gyne surgery:  local anesthesia (for extremely small cases), twilight sleep and general anesthesia.  Any of them can be administered by an MD anesthesiologist or a competent CRNA (nurse anesthetist).  Similarly, surgery can be performed in a hospital or in a surgeon's accredited operating room facility.

In my practice, I have my own accredited operating room and I use twilight sleep anesthesia which is provided by a separate anesthesiologist, who has been with me for over 21 years. His job is to keep the patient comfortable and safe. I do not believe a surgeon should administer his own sedation to the patient -- except in very limited circumstances.  The surgeon should be concentrating on the surgery -- not attending to the patient's pain/discomfort at the same time.

Dr Jacobs