title: Duration of anesthesia as an indicator of morbidity and mortality in office-based facial plastic surgery: a review of 1200 consecutive cases.
abstract: OBJECTIVE
  To define whether duration of anesthesia is an indicator of patient morbidity and mortality in facial plastic surgery performed in an accredited office-based surgical facility.
  
  
  METHODS
  A prospective and retrospective outcomes analysis of 1200 consecutive patients who underwent facial plastic surgery from July 1995 to February 2005. Outcomes of patients who underwent surgery with anesthesia for less than 240 minutes were compared with those of patients who underwent surgery with anesthesia for more than 240 minutes.
  
  
  RESULTS
  Of the 1200 cases analyzed, in 1032 (86%), duration of anesthesia was longer than 240 minutes. There were no deaths and no cases of myocardial infarction or pulmonary embolism in this study group. Morbidity in the 1200 cases was reported as follows: 1 case of respiratory failure, 1 case of central nervous system deficit, 1 case of adverse reaction to medication, and 1 case that required transfer to a hospital. There were 6 cases of prolonged recovery from anesthesia. Incidences of major morbidity in the group of 168 patients (14%) whose anesthesia lasted less than 240 minutes were the same as in the group whose anesthesia lasted more than 240 minutes.
  
  
  CONCLUSIONS
  In an accredited office-based facial plastic surgery facility, anesthesia duration is not an indicator of patient morbidity and mortality. Combined facial plastic surgery procedures, using general anesthesia, can be accomplished safely in the office-based environment, and inpatient care would not have altered morbidity in this study group.
authors.affiliation: Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Conn, USA. ng3364@aol.com
authors.forename: Neil A
authors.initials: NA
authors.lastname: Gordon
authors.forename: Marc E
authors.initials: ME
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D000758:Anesthesia / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000009:adverse effects*; D013997:Time Factors