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Comparative Study
. 2025 Jul;49(14):4025-4033.
doi: 10.1007/s00266-025-04867-z. Epub 2025 Apr 28.

Propofol Dexmedetomidine Total Intravenous Anesthesia with Tumescent Anesthesia in Aesthetic surgery

Affiliations
Comparative Study

Propofol Dexmedetomidine Total Intravenous Anesthesia with Tumescent Anesthesia in Aesthetic surgery

James Roy Kanjoor et al. Aesthetic Plast Surg. 2025 Jul.

Abstract

Background: Total intravenous anesthesia (TIVA) is commonly performed in ambulatory aesthetic surgery centers. The authors compared combination of TIVA and tumescent anesthesia for safety and efficacy in prolonged and successive multiple aesthetic procedures.

Methods: A retrospective review of patients who underwent aesthetic surgery procedures under TIVA from 2016 through 2024 at the authors' aesthetic surgery center was conducted. Patients were included if they fulfilled ASA 1 or 2 staging, BMI < 45 and were of age between 12 and 80 years. Perioperative drug dosages, time under anesthesia and patient vitals were recorded.

Results: Of the 307 patients assessed, 301 completed surgery under TIVA and 6 were converted to GA. No major morbidity was recorded and all 307 cases were discharged from Anesthesia Recovery at 6 hours post-surgery. Average duration of anesthesia time was highest for lipoabdominoplasty (278 min, range 170-360 min). Average dose of tumescent anesthesia was highest in excisional body contouring (2967 ml). No surgical morbidity, e.g., skin necrosis, hematoma and blood transfusion, was reported. No anesthetic morbidity, e.g., deep vein thrombosis, fat embolism and lignocaine toxicity, was reported. Mean arterial pressure and SpO2 were maintained in safe normal range (70-100 mm Hg and > 95%, respectively) up to 6 hours postoperative. Aldrete score for postoperative recovery was > =9 at 10 min for 80% cases (n= 245).

Conclusions: The analysis of 307 total intravenous anesthesia with tumescent anesthesia cases demonstrated the overall safety and efficacy of the propofol-dexmedetomidine protocol under deep sedation. The study underscores the importance of complete preoperative assessments, vigilant anesthetist-guided drug infusions and monitoring for complications.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Aesthetic surgery; Daycase surgery; Dexmedetomidine; Propofol; TIVA.

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Conflict of interest statement

Declarations. Conflict of interest: The authors state that they have no undisclosed source of funding. The authors declare no conflicts of interest concerning the research, authorship and/or publication of this article. Ethical Approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed Consent: Informed consent was obtained from all study participants.

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