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Local Anaesthetic and Sedation – Revolutionising Recovery

The most commonly documented preoperative fear is of anaesthesia. Most of the cosmetic surgery at The Westbourne Centre is either carried out under local anaesthetic or a combination of local anaesthetic with sedation. This means that recovery of patients from anaesthesia is rapid so that procedures that previously required hospital stay overnight can be carried out as day cases.

Local anaesthetic is usually administered by injections via fine needles and renders an operative area free from pain. This is usually carried out by the surgeon. A mixture of short and long acting drugs are infiltrated directly into the tissues. Sometimes the major nerves supplying an area can be blocked with local anaesthetic so that large areas can be made numb. This is known as regional anaesthesia. These techniques provide analgesia both during the surgery and for the immediate postoperative period. This aids rapid recovery.

Sedation is often used in conjunction with local anaesthesia to allow the patient to experience surgery without stress or pain. Agents such as Remifentanil and Propofol are used and are given directly in to the patient’s veins. These are powerful analgesic (pain killing) and sedative drugs but are very short acting. With the use of modern infusion pumps, small continuous doses can be delivered and their effects accurately controlled.

Patients usually prefer not to remember anything about their procedure, but for patients who do want recall, the sedation can be adjusted so that they are fully awake but pain free.  The major difference with general anaesthesia is that with local anaesthetic and sedation, patients breathe on their own and do not require intubation (a breathing tube placed in the airway to keep the lungs inflating). With local anaesthetic and sedation there is a diminished incidence of nausea and vomiting, and recovery is more rapid. This in turn diminishes complications associated with slow postoperative recovery, such as deep vein thrombosis and pulmonary embolus.

Local anaesthetic and sedation

The Westbourne Centre have been using these techniques for the last four+ years and it succeeds because of the very close teamwork between the surgeons and highly skilled anaesthetists who deliver the drugs and carefully monitor the patient.  Survey results of our patient satisfaction scores at The Westbourne Centre have been consistently high. We believe that this has been a significant advancement in the quality of healthcare delivery for cosmetic patients.

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    Hiroshi Nishikawa

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    Reconstructive, craniofacial and cosmetic consultant surgeon, my principal work is with the Birmingham Children's and Queen Elizabeth hospitals and the Westbourne Centre, a private medical centre in Edgbaston.

  • British Association of Aesthetic Plastic Surgeons

  • Royal Society of Medicine

  • Plastic Surgeon


About Mr Nishikawa