General or local anesthesia?

[gynela]

I have had several surgical consultations and a few doctors say local anesthesia is fine others say you must have general anesthesia.  This procedure will have both lipo and tissue extraction.  One doctor indicated that because of the stress of the lipo part of the procedure, that requires general.  My question is is general required or is being awake ok?  Does it make a difference in the final result?  Or is it simply a doctor's preference?

[Dr. Elliot Jacobs]

Every surgeon has his preference for what type of anesthesia is to be used.  It will depend on his experience as well as the extent of the contemplated surgery.

I use "twilght sleep" anesthesia in my practice -- which is mid-way between general and local.  It requires the presence of an anesthesiologist to administer short acting medications so that the patient is sleeping.  I then administer local anesthesia.  The sedation alone -- without the local -- would not be sufficient.  And in my mind, the local alone, without the sedation, is not sufficient to make the patient absolutely comfortable.

Some patients will make a decision about anesthesia based on price -- local usually requires minimal or no additional cost while general anesthesia can be expensive.  This is a very foolish decision.  IMHO, only the smallest gyne can be treated with local alone.  When liposuction is used (and it is needed in many cases), it adds a degree of pain that local anesthetics do not cover -- and the patient pays the price in terms of very bad pain during the procedure.  When the patient is moving due to pain, the surgeon cannot do his best work.  The result is often a bad experience for the patient and a poor outcome for the surgery.

The ideal situation is therefore a comfortable, virtually pain free experience for the patient.  Since this will (hopefully) be a once in a lifetime operation, why subject oneself to considerable pain?

Dr Jacobs

[shreyas24]

Local anesthesia...