RESUMEN
A thorough medical history is critical in patient selection for local anesthesia facelifting. Patients with no prior issues with dental procedures and no history of significant anxiety are better candidates. Simplifying local anesthesia mixtures and using dilute concentrations will minimize dosing errors and decrease risk of local anesthesia toxicity. Oral anxiolytics can be used with caution to minimize patient anxiety. Pulse oximetry, telemetry, and blood pressure monitoring should be performed with any addition of oral or IV sedation/anxiolytic. The short-scar anterior facelift is ideal for local anesthesia due to the limited deep-plane dissection and shorter procedure duration.
Asunto(s)
Anestesia Local/métodos , Anestésicos Locales , Bupivacaína , Lidocaína , Ritidoplastia/métodos , Anestésicos por Inhalación , Anestésicos Locales/efectos adversos , Bupivacaína/efectos adversos , Sedación Consciente , Sedación Profunda , Humanos , Hipnóticos y Sedantes , Lidocaína/efectos adversos , Monitoreo Intraoperatorio , Música , Óxido Nitroso , Selección de PacienteRESUMEN
BACKGROUND: Nasal tip amputation is a rare but difficult problem to manage. Nonmicrovascular nasal tip replantation is a valid and relatively simple repair option for moderate nasal defects, but tissue ischemia and graft failure occur frequently. CASE REPORT: We present the case of a pediatric nasal tip amputation from a dog bite treated with replantation within 5 hours. The 2.5-cm avulsed tip contained skin, cartilage, and mucosa and was replanted as a 3-layer composite graft. Hyperbaric oxygen (HBO) therapy was initiated for 2 weeks postoperatively. The outcome was functionally adequate, and the majority of the native nasal tissue was salvaged. CONCLUSION: HBO therapy can be used after nonmicrovascular nasal tip replantation to improve graft survival and potentially decrease the need for revision surgery.