New Haven, Conn. — Researchers at the Yale University School of Medicine report that risk of complications or death does not appear to be linked to the amount of time patients spend under anesthesia during facial plastic surgery.
As the result of several deaths in office-based plastic surgery facilities, some state regulatory agencies and medical boards have developed policies regarding in-office procedures. Pennsylvania and Tennessee, for example, have mandated that surgeries longer than four hours be performed at an in-patient facility.
But Neil Gordon, M.D., clinical instructor in the Department of Surgery at Yale, said the data on which regulatory bodies base these types of decisions is inconclusive.
Dr. Gordon and research co-author Mark Koch, M.D., of the State University of New York at Stony Brook, evaluated 1,200 patients who had undergone facial plastic surgery. Of those, 1,032 were under anesthesia for more than four hours. Most of the patients in the group receiving longer anesthesia underwent multiple facial procedures, while most in the group receiving shorter anesthesia only had rhinoplasty.
Their study reports that no deaths occurred the day after surgery and that the rate of complications was similar regardless of the duration of anesthesia . Of the 1,200 patients, only three — among them one who received shorter anesthesia — developed major complications, including respiratory failure, nervous system deficit and an adverse reaction to medication.
The study concludes that when regulatory agencies consider creating surgical guidelines, they should do so with a comprehensive understanding of specific risks associated with different types of surgery. In this way, the study says, generalizations and inappropriate, non-data-driven regulations can be avoided.