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Aesthetic Plast Surg. 2018 Jun;42(3):891-898. doi: 10.1007/s00266-018-1122-1. Epub 2018 Apr 2.

Judicial Precedent-Based Clinical Practice Guidelines of Propofol in Sedative Esthetic Surgery.

Author information

1
Department of Emergency Medicine, College of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
2
Department of Surgery, College of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
3
Department of Plastic Surgery, College of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea. monkeyhong@hanmail.net.

Abstract

BACKGROUND:

Propofol is has been widely used for sedation in the field of esthetic surgery because of its favorable pharmacokinetic profile. Propofol sedation-induced side effects are rare. However, when present, they can be serious. The number of malpractice claims associated with propofol sedation has increased in recent years. This study aims to show which procedures lead to the most claims in the field of esthetic surgery through a review of Korean precedents.

METHODS:

Thirteen precedent cases of propofol sedation in the field of esthetic surgery were collected between 2000 and 2016. We analyzed the type of procedure, administration route, anesthesia provider, complications, timing of damaging events, average indemnification, plaintiff's (patients) winning rate, ratio and the reason of limitation of liability and the key factors affecting the judgement in these cases.

RESULTS:

Most plaintiffs were women, and in most cases (11/13, 73.3%), the times of the damaging events were in maintenance and the anesthesia provider was the surgeon. The most common complication related to propofol sedation was hypoxic brain damage. Among the 13 cases, 12 were won by the plaintiff. The mean claim settlement was 339,455,814 KRW (USD 301,792.15). The key factors affecting the judgement were administration method and staff, monitoring method, preparation of emergency kit, response to emergencies, transfer to a higher-level hospital, detailed medical recording about event and informed consent.

CONCLUSION:

The number of claims owing to propofol sedation after esthetic surgery is increasing. Close monitoring during the operation, immediate reaction to an event and thorough medical records were main key factors that influenced the judgement. Preoperative explanation about the possibility of complications was important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns.

LEVEL OF EVIDENCE V:

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:

Esthetic surgery; Malpractice litigation; Propofol sedation

PMID:
29610953
DOI:
10.1007/s00266-018-1122-1

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