Anesthesia during grinding
Last reviewed: 23.04.2024
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Facial grinding is performed under application, infiltration, regional, intravenous or general anesthesia. Sometimes an application anesthetic, such as EMLA cream, can be used for a single surface pass of an erbium laser. Each additional passage requires additional anesthesia. However, the EMLA cream does not provide adequate analgesia for carbon dioxide laser grinding. To optimize the surgeon's ability to see the depth of treatment under local infiltration anesthesia, it is important that the anesthetic either does not contain epinephrine, or its concentration should be no higher than 1: 400,000.
To get a good analgesia, it is enough to apply a dilute solution of lidocaine (0.05%), the same as with liposuction with hypotonic infiltration, in combination with blockade of the central nerves of the face. It is necessary to correctly estimate the depth of grinding. If the anesthetic contains too much adrenaline, then the pink color, indicating penetration into the papillary layer of the dermis, may not be visible. In the same way, a high concentration of adrenaline can conceal point bleeding when the erbium laser penetrates the papillary layer. Local anesthesia can be supplemented with intravenous if necessary. General anesthesia with intubation of the trachea is associated with a greater risk of inflammation associated with the use of oxygen and the use of the endotracheal tube. Currently, there are metal endotracheal tubes and a coating for plastic foil tubes, designed specifically for working with lasers and preventing the ignition of plastic.
Preventive antibiotic therapy causes even more contradictions. Many surgeons prescribe antibiotics before and after polishing to reduce the risk of developing a bacterial infection under a long-term or closed mask bandage. Others believe that antibiotic prophylaxis does not reduce the chances of a postoperative infection. Doctors who use antibiotic prophylaxis often prescribe to their patients and antimycotics to prevent fungal infection under the bandages.
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