Total intravenous anesthesia for office-based laser facial resurfacing

Providing general anesthesia in an office-based setting can be time consuming, risky, and expensive. The purpose of this study was to describe a technique for total intravenous anesthesia (TIVA) technique that can be easily utilized by anesthesiologists in an office-based setting for laser facial resurfacing.

Twenty-five American Society of Anesthesiologists (ASA) status classification I-II patients (22 females and three males) elected general anesthesia for laser facial resurfacing. All patients were premedicated with glycopyrrolate (0.2 mg IV). All anesthetics were administered by board-certified anesthesiologists, and ASA Standards for Anesthesia Monitoring were strictly followed. An induction dose of propofol (2. 0-2.5 mg/kg IV) was followed by laryngeal mask airway insertion (size 3 or 4). TIVA was maintained with a propofol infusion (50-250 mcg/kg/minute IV). Supplemental midazolam (2-4 mg IV), fentanyl (0. 05-0.20 mg IV), and oxygen (2-4 l/minute) were administered as needed. After completion of the laser procedure, TIVA was discontinued and the patients were allowed to awaken. Patients were discharged after achieving a Modified Post-Anesthetic Discharge Score of >/= 9.

Mean procedure duration was 48 +/- 21 minutes, and time to discharge after the procedure was 16 +/-6 minutes. All procedures and anesthetics were well tolerated and without complications. The only post-procedure complaint was an isolated, minor, and temporary sore throat.

TIVA is an excellent method for providing anesthesia for laser facial resurfacing in an office-based setting.