Blood gas and hemodynamic effects of sedatives and analgesics when used as a supplement to local anesthesia in plastic surgery.

In 20 patients undergoing a rhinoplasty or rhytidectomy under local anesthesia combined with intravenous sedatives and hypnotics, fairly satisfactory operating conditions were obtained. This technique was associated with respiratory depression and hypoxia, however, with statistically significant elevations in the arterial carbon dioxide tensions, and depressions in the arterial oxygen tensions. We now advocate the routine use of supplement oxygen and periodic deep breathing during the operation, and in the immediate postoperative period. We will continue to advise the use of general anesthesia in patients with cardiopulmonary disease. The mental detachment and inability to articulate discomfort during the procedure are major disadvantages to the use of fentanyl and droperidol in these patients.