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A Review of 1200 Consecutive Cases

Neil A. Gordon, MD; Marc E. Koch, MD

Arch Facial Plast Surg. 2006;8:47-53.

Objective  To define whether duration of anesthesia is an indicator of patient morbidity and mortality in facial plastic surgery performed in an accredited office-based surgical facility.

Design  A prospective and retrospective outcomes analysis of 1200 consecutive patients who underwent facial plastic surgery from July 1995 to February 2005. Outcomes of patients who underwent surgery with anesthesia for less than 240 minutes were compared with those of patients who underwent surgery with anesthesia for more than 240 minutes.

Results  Of the 1200 cases analyzed, in 1032 (86%), duration of anesthesia was longer than 240 minutes. There were no deaths and no cases of myocardial infarction or pulmonary embolism in this study group. Morbidity in the 1200 cases was reported as follows: 1 case of respiratory failure, 1 case of central nervous system deficit, 1 case of adverse reaction to medication, and 1 case that required transfer to a hospital. There were 6 cases of prolonged recovery from anesthesia. Incidences of major morbidity in the group of 168 patients (14%) whose anesthesia lasted less than 240 minutes were the same as in the group whose anesthesia lasted more than 240 minutes.

Conclusions  In an accredited office-based facial plastic surgery facility, anesthesia duration is not an indicator of patient morbidity and mortality. Combined facial plastic surgery procedures, using general anesthesia, can be accomplished safely in the office-based environment, and inpatient care would not have altered morbidity in this study group.

Author Affiliations: Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Conn (Dr Gordon); New England Surgical Center at The Retreat at Split Rock, Wilton, Conn (Dr Gordon); Department of Anesthesiology, School of Medicine, State University of New York at Stony Brook (Dr Koch); and Resource Anesthesiology Associates, PC, New Rochelle, NY (Dr Koch).

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