Consideration on Application of Modified Monitored Anesthetic Care in Plastic Surgery

성형외과 영역의 수술 시 마취하 감시관리의 응용에 대한 고찰

  • Cho, Geon (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Suh, In-Suck (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Choi, Young-Ryong (Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Chung, Mi-Hwa (Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Tak, Kyoung-Seok (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Park, Young-Kyu (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Kim, Jae-Hyun (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Ko, Eung-Yeol (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Sung, Ha-Min (Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center)
  • 조건 (한림대학교 의과대학 강남성심병원 성형외과학교실) ;
  • 서인석 (한림대학교 의과대학 강남성심병원 성형외과학교실) ;
  • 최영룡 (한림대학교 의과대학 강남성심병원 마취통증의학교실) ;
  • 정미화 (한림대학교 의과대학 강남성심병원 마취통증의학교실) ;
  • 탁경석 (한림대학교 의과대학 강남성심병원 성형외과학교실) ;
  • 박영규 (한림대학교 의과대학 강남성심병원 성형외과학교실) ;
  • 김재현 (한림대학교 의과대학 강남성심병원 성형외과학교실) ;
  • 고응열 (한림대학교 의과대학 강남성심병원 성형외과학교실) ;
  • 성하민 (한림대학교 의과대학 강남성심병원 성형외과학교실)
  • Received : 2010.04.14
  • Accepted : 2010.10.25
  • Published : 2011.01.10

Abstract

Purpose: Many patients have fear for surgery owing to the injection of lidocaine and the possible pain in the course of the operation. To resolve such a problem the cases to do plastic surgery with monitored anesthetic care are increasing, in which something like sedatives is injected into vein without endotracheal intubation and under voluntary respiration, but the usage is now under the controversy. Methods: There were 25 patients who had surgery with local anesthesia, and another 25 patients who had surgery with monitored anesthetic care which belongs to ASA class 1 and 2 from January to April, 2009. Their anesthesia records were collected and surveys were given before and after the surgery and the surgery staff recorded OAA/S during the surgery. The postoperative surveys included the awakening during the surgery, pain, anxiety, and the degree of patient's satisfaction through visual analogue scale to identify the difference between the two methods. Results: The OAA/S results according to time lapse show that it is possible to lead a fast effective sedation and recovery with monitored anesthetic care, and monitored anesthetic care enhances both surgeon's convenience level and patient's satisfaction level, and reduces awakening, pain, and anxiety, compared to local anesthesia. Conclusion: The current paper shows about the plastic surgery, particularly the outpatient surgery, when monitored anesthetic care method is applied, it could gain a fast sedation and recovery or an effective sedation of patients. The method also has some affirmative effects in regard with surgeon's convenience and the patients' satisfaction degree and the reduction of their awakening, pain, and anxiety. With careful and adequate watch on the measures about vital signs like electrocardiogram, the degree of oxygen saturation, and blood pressure, it could clinically be very useful.

Keywords

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