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Related Experiment Video

Updated: May 15, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery

Non-Intubated Video-Assisted Thoracoscopic Surgery

Published on: May 26, 2023

Office-based outpatient plastic surgery utilizing total intravenous anesthesia.

Colin Failey¹, Jaime Aburto, Hector Garza de la Portilla

¹Methodist Hospital Plastic Surgery Program, Houston, TX 77024, USA.

Aesthetic Surgery Journal

|January 22, 2013

Summary

Total intravenous anesthesia (TIVA) is a safe and effective option for office-based plastic surgery, offering moderate to deep sedation without intubation. This technique is associated with minimal complications, making outpatient procedures a viable choice for many patients.

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Area of Science:

Anesthesiology
Plastic Surgery
Ambulatory Surgery

Background:

Office-based plastic surgery is increasingly popular.
Anesthetic techniques range from conscious sedation to general anesthesia.
Total intravenous anesthesia (TIVA) provides moderate to deep sedation without intubation, suiting office settings.

Purpose of the Study:

To review plastic surgery procedures performed under TIVA in an outpatient office-based operating room.
To assess patient outcomes and complications associated with TIVA in this setting.

Main Methods:

Retrospective chart review of 2611 procedures (2003-2011) by 2 senior surgeons.
TIVA administered by a board-certified anesthesiologist; conscious sedation by the plastic surgeon.
Analysis of patient outcomes and complications to evaluate TIVA safety.

Main Results:

No deaths, cardiac events, or hospital transfers occurred in 2006 patients.
642 patients received TIVA (propofol and/or ketamine with midazolam/fentanyl); 1364 received conscious sedation.
One case (0.05%) of DVT/PE in a patient on oral contraceptives undergoing implant exchange under TIVA.

Conclusions:

Office-based surgery is an attractive option for patients.
TIVA can be used safely for various procedures in office operating rooms.
TIVA minimizes risks associated with general anesthesia and leads to few postoperative complications when patient selection is prioritized.