Is it safe to have your surgeon manage a Demerol twilight anesthesia during a facelift?
There are many plastic surgeons who do their own sedation and/or supervise the administration of sedation medications.
Make sure the facility is accredited.
My personal preference is to have the MD anesthesiologist administer and monitor the anesthesia and sedation. This will be more expensive, because you will pay for anesthesia fees.
In general it is a good idea to have the surgeon focus on the surgery and someone else doing monitoring and sedation. This can either be an anesthesiologist, a nurse under the doctor's supervision, or a nurse anesthetist (CRNA).
Twilight anesthesia for a facelift can be safe if there is an experienced nurse monitoring you and the procedure is done in an accredited facility. Having an MD Anesthesiologist do the anesthesia, however, is generally safer and would be my choice if I were the patient. It can also be about the same cost as twilight anesthesia since it generally cuts time off the procedure and the saved time can sometimes pay for the anesthesia.
Safety should always be the primary concern. While some surgeons manage the anesthesia and also simultaneously perform the surgery, the safer method is for the surgeon to concentrate on the surgical procedure and have a board certified anesthesiologist or certified nurse anesthetist provide and monitor the anesthesia.
There are a variety of effective anesthesia techniques, including "twilight" anesthesia, which utilize different approved pharmaceutical agents. No matter which drug or drugs are administered, surgery should only be performed by a board certified plastic surgeon, in a licensed hospital, or more commonly today, in an accredited office-based or ambulatory surgical facility, which is inspected by a recognized nationally recognized accrediting organization like the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). The surgeon should have hospital privileges for the procedures that will be performed in any facility.
Robert Singer, MD FACS