Operations in oculoplastic surgery may be performed under local or general anesthesia. The decision on the type of anesthesia is made by the surgeon, in consultation with the patient, based on the following criteria:
Local anesthesia requires cooperation on the part of the patient, who has to lie still during surgery. This is why it is not suitable for children. Local anesthesia is usually supplemented with sedatives and painkillers (intra-venous analgo-sedation), with anesthetist monitoring. This approach is especially important in patients who are not suitable for general anesthesia, due to health issues.
In certain operations, local anesthesia is preferred. This is the case in adult ptosis surgery, in which patient cooperation is needed to adjust the height of the upper lid.
On the other hand, operations that are time-consuming and complex, require general anesthesia. In such cases, pre-operative laboratory tests and physical exams are needed to verify that the patient is fit for this kind of anesthesia.
Regardless of the type of anesthesia, the surgeon and anesthetist have to be informed about any medications the patient is taking, as well as any allergies to medications.
In oculoplastic surgery, it is very important for the surgeon to be aware if the patient is taking „blood thinners“ (anti-aggregation and anti-coagulant drugs). These medicines are used in the prevention and treatment of cardiovascular diseases. The most frequently used among them is Aspirin, which, with the permission of the treating doctor, needs to be discontinued 10 - 14 days prior to surgery, in order to prevent uncontrollable bleeding during and after surgery. This can also be caused by dietary supplements such as Gingko Biloba, Ginger, Ginseng, Omega fatty acids and Vitamin E.