Dr. Solomon contributed to the medical journal Clinics in Plastic Surgery. The article is entitled “Rhinoplasty with Intravenous and Local Anesthesia”.
The online version of the article contains a number of videos featuring Dr. Solomon. In them, he performs septoplasty, rhinoplasty, nose tip shaping, Caucasian and non Caucasian rhinoplasty. Furthermore, these videos include a detailed segment in which Dr. Solomon demonstrates a rhinoplasty procedure on a female patient of African American heritage.
Procedural sedation for a rhinoplasty, like any procedure, relies on careful patient selection. Patient and surgeon compliance is vital.
Any person eligible for the procedure should have an American Society of Anesthesia (ASA) score of 1 or 2, with a possibly well-controlled 3 also acceptable. Furthermore, they should be devoid of certain comorbidities, including obstructive sleep apnea, gastroesophageal reflux disease, and obesity (body mass index =35).
Before the procedure begins, clinicians must explicitly communicate to patients that they will feel no pain. However, under some anaesthetics, they may know what is occurring during surgery, but they should not care. A common misconception about sedation is that it involves general anesthesia without an airway. For this reason, clinicians must reassure patients that the anesthetist will be with them the entire time. This way, any discomfort can be dealt with immediately and the anesthesia titrated to an acceptable level.
Jul 14th 2014