In yesterday’s blog post from The Eisemann Plastic Surgery Center, we discussed a comparison between general anesthesia and a protocol of IV sedation and intercostal nerve blocks. Though not every plastic surgery procedure or every patient is a good candidate for this protocol, it proves to be beneficial both medically and in terms of cost to the patient. Breast augmentation (with and without breast lift) are well suited for this protocol because they are relatively short surgical procedures. Intercostal nerve blocks affect the intercostal nerves located in the chest/thoracic region, and these nerves are located under the skin under each rib. The injection effectively blocks the nerves that would create a pain response, and the effect of the injection lasts several hours. In addition to intercostal nerve blocks, Dr. Eisemann often uses IV sedation in his nationally accredited surgical facility in the office. The initial dose of IV sedation is administered by Dr. Eisemann, and it may include a combination of midazolam, fentanyl and ketamine. The circulating nurse may give additional dosing of the sedating drugs during surgery if necessary to keep the patient comfortable. Since general anesthesia may be avoided in some plastic surgery procedures, this eliminates the necessity for a physician anesthesiologist and/or licensed anesthesia nurse as well as hospital admission. These components are sometimes necessary depending on the plastic surgery procedure and patient, but they do come at an extra cost and can create some unpleasant side effects to the patient.