General or IV Anesthesia: What is the Difference and Which is Better?

When it comes to plastic surgery procedures, plastic surgeons use a variety of anesthetic techniques and medication agents. At our AAAASF surgical facility here at Precision, we use a combination of intravenous and subcutaneous injectable medications for a comfortable and safe experience. There are different descriptions of anesthesia and they don’t always mean the same thing.

General Anesthesia typically means the provider controls your breathing with an endotracheal tube. Inhalational agents and IV medications are used but the important point is a breathing device is placed in your trachea to control and support your breathing. In order to accomplish placement of the endotracheal tube, some of the medications sedate heavily and chemically paralyze the body. By doing so, the tube is used as a conduit to provide breathing for you during surgery. This technique is needed when very heavy sedation or chemical paralysis is required and in patients with many medical problems require surgery. Aside from placement of the breathing tube, additional medications are still required to prevent a patient from having pain even though they are chemically paralyzed and not breathing on their own. For a healthy patient undergoing cosmetic plastic surgery procedures, this level of anesthesia is not usually required or necessarily the best choice.

On the other hand, IV anesthesia can have a wide range of differences and definitions. IV sedation can consist of narcotics and benzodiazepines which can make a person more comfortable but may or may not affect the consciousness. It may or may not be combined with local anesthetic. Total IV anesthesia, or TIVA, at Precision Plastic Surgery is combined with local anesthetic to accomplish a completely anesthetized unconscious effect while the patient maintains their respirations throughout the entire operation. Because the patient is able to breathe and move on their own, both the surgeon and the anesthesiologist are aware of any discomfort way before the patient becomes conscious of it. They can respond appropriately by giving more local anesthetic or increasing the level of IV anesthesia.
Continual monitoring is performed on both the oxygen intake and amount of breathing during respirations. It is paramount though, that the right patient candidate is selected for an appropriate surgical procedure to utilize this type of anesthesia.

Advantages of TIVA vs General Anesthesia

As discussed above, with general anesthesia, many times the body is chemically paralyzed. By doing so, this could increase the risk of a deep venous thrombosis (DVT) of the legs or pulmonary embolus (PE) of the lungs. With TIVA, the body is never paralyzed and muscles are always functioning which dramatically reduces the risk of DVT or PE.

Many of the inhalational agents used in general anesthesia can cause significant nausea and vomiting for multiple days. Nausea and vomiting is very minimal if existent at all with TIVA at Precision.
General anesthetic has also shown, especially in operations over 4 hours, the cardiovascular system is stressed greatly which could lead to a myocardial infarction. IV anesthesia in the setting of elective plastic surgery does not cause the level of stress on the heart even with very long operative procedures.

Anesthesia is also a cumulative effect, particularly with inhalational agents during general anesthesia. Because of this, several hours of anesthesia can cause a person to require several hours if not days in the hospital during to recovery before the anesthesia “wears off”. By utilizing the right medications intravenously during TIVA in combination with local anesthetic, even a surgery performed lasting most of the day will result in a recovery of 1-2 hours and the ability to go home. This is not the normal result following general anesthesia after a long operation.

Come Experience the Precision Difference

Dr. McFate started Precision to provide Austin and the surrounding communities with a new precisely patient oriented surgical experience. We have a fully equipped operative suite where patients can undergo a wide variety of surgical procedures just within the confines that is surrounded by some of the most beautiful outdoor scenery in all of Texas.

Precision Plastic Surgery is proud to announce the on-site surgery suite is accredited through the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).

To learn more about Precision visit: About Us