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Outpatient anesthesia

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https://www.readbyqxmd.com/read/27918331/growth-of-nonoperating-room-anesthesia-care-in-the-united-states-a-contemporary-trends-analysis
#1
Alexander Nagrebetsky, Rodney A Gabriel, Richard P Dutton, Richard D Urman
BACKGROUND: Although previous publications suggest an increasing demand and volume of nonoperating room anesthesia (NORA) cases in the United States, there is little factual information on either volume or characteristics of NORA cases at a national level. Our goal was to assess the available data using the National Anesthesia Clinical Outcomes Registry (NACOR). METHODS: We performed a retrospective analysis of NORA volume and case characteristics using NACOR data for the period 2010-2014...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27917806/comparison-of-intrathecal-plain-articaine-and-levobupivacaine-with-fentanyl-for-caesarean-section
#2
Rüveyda I Demircioglua, Muhammet Gozdemira, Burhanettin Ustaa, Hüseyin Serta, Safinaz Karabayirlia, Bünyamin Muslua, Esra A Keskinb
PURPOSE: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. METHODS: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 µg intrathecally...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27906941/epidural-blood-patch-for-the-treatment-of-spontaneous-and-iatrogenic-orthostatic-headache
#3
Yun So, Jung Min Park, Pil-Moo Lee, Cho Long Kim, Cheolhan Lee, Jae Hun Kim
BACKGROUND: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. OBJECTIVE: We conducted this study to compare the efficacy and number of epidural blood patches for spontaneous and iatrogenic orthostatic headaches...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#4
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27876719/-local-anesthesia-selection-algorithm-in-patients-with-concomitant-disease-part-2
#5
E N Anisimova, S T Sokhov, N Yu Letunova, I V Orekhova, M V Gromovik, E A Erilin, N A Ryazantsev
A group of authors presents the rationale for local anesthesia selection in patients with concomitant disease based on case history; interaction analysis of drugs with local anesthetic and sedation agents; estimation of patient functional status; patient anxiety correction; dental care with hemodynamics monitoring. It was found that adhering to this algorithm promotes the prevention of urgent conditions in outpatient settings.
2016: Stomatologii︠a︡
https://www.readbyqxmd.com/read/27872974/interest-of-using-ropivacaine-for-outpatient-laparoscopic-cholecystectomy-prospective-randomized-trial
#6
Emeric Abet, François Orion, Fabrice Denimal, Anne-Géraldine Brau-Weber, Benoît de Kerviler, Marc-Henri Jean, Guillaume Boulanger, Jérôme Dimet, Michel Comy
BACKGROUND: The objective of this study was to evaluate the interest of using ropivacaine for outpatient laparoscopic cholecystectomy. The use of local anesthesia by instillation and infiltration could reduce pain and increase the number of outpatient cholecystectomies. METHODS: A one-center randomized prospective clinical trial compared the use of ropivacaine during outpatient laparoscopic cholecystectomy to the control group of outpatients for laparoscopic cholecystectomy between April 2014 and May 2015...
November 21, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27871557/effect-of-adjunctive-dexmedetomidine-on-postoperative-intravenous-opioid-administration-in-patients-undergoing-thyroidectomy-in-an-ambulatory-setting
#7
Kristin Long, Joseph Ruiz, Spencer Kee, Alicia Kowalski, Farzin Goravanchi, Jeff Cerny, Katy French, Mike Hernandez, Nancy Perrier, Elizabeth Rebello
STUDY OBJECTIVE: Two of the most feared complications for patients undergoing thyroid surgery are pain and postoperative nausea and vomiting. Thyroidectomy is considered high risk for postoperative nausea and vomiting, and recent studies have looked at adjuncts to treat pain, limit narcotic use, "fast-track" the surgical process, and enhance recovery without compromising the patient's safety. One such perioperative medication of interest is dexmedetomidine (Dex), a centrally acting α-2 agonist that has been associated with reducing pain and postoperative opioid consumption...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869630/a-prospective-evaluation-of-opioid-utilization-after-upper-extremity-surgical-procedures-identifying-consumption-patterns-and-determining-prescribing-guidelines
#8
REVIEW
Nayoung Kim, Jonas L Matzon, Jack Abboudi, Christopher Jones, William Kirkpatrick, Charles F Leinberry, Frederic E Liss, Kevin F Lutsky, Mark L Wang, Mitchell Maltenfort, Asif M Ilyas
BACKGROUND: Although adequate management of postoperative pain with oral analgesics is an important aspect of surgical procedures, inadvertent overprescribing can lead to excess availability of opioids in the community for potential diversion. The purpose of our study was to prospectively evaluate opioid consumption following outpatient upper-extremity surgical procedures to determine opioid utilization patterns and to develop prescribing guidelines. METHODS: All patients undergoing outpatient upper-extremity surgical procedures over a consecutive 6-month period had the following prospective data collected: patient demographic characteristics, surgical details, anesthesia type, and opioid prescription and consumption patterns...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27867853/treatment-of-vesico-ureteral-reflux-in-infants-and-children-using-endoscopic-approaches
#9
REVIEW
Manabu Okawada, Ciro Esposito, Maria Escolino, Alessandra Farina, Mariapina Cerulo, Francesco Turrà, Atsuyuki Yamataka
Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Endoscopic treatment of VUR dates back to 1981 when Matouschek first described injection of the ureteral orifice in an attempt to correct VUR. In addition, also Politano and colleagues and McDonald described successful correction of reflux using endoscopic techniques. After these reports subureteral Teflon injection (STING) came to be appreciated as a viable new way to less invasively correct one of the most common pediatric urologic problems...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#10
REVIEW
Luca Bertolaccini, Andrea Viti, Simona Paiano, Carlo Pomari, Luca Rosario Assante, Alberto Terzi
Malignant pleural effusion (MPE) symptoms have a real impact on quality of life. Surgical approach through video-assisted thoracic surgery provides a first step in palliation. In patients unfit for general anesthesia, awake pleuroscopy represents an alternative. Sclerosing agents can be administered at the bedside through a chest tube. Ideal treatment of MPE should include adequate long-term symptom relief, minimize hospitalization, and reduce adverse effects. Indwelling pleural catheter (IPC) allows outpatient management of MPE through periodic ambulatory fluid drainage...
February 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27865218/-percutaneous-endovascular-aortic-repair-with-local-anesthesia-one-day-surgery
#11
Joel Sousa, Daniel Brandão, Paulo Barreto, Joana Ferreira, José Almeida Lopes, Armando Mansilha
INTRODUCTION: To evaluate the results of the abdominal aortic aneurism endovascular treatment (EVAR), percutaneously and with local anesthesia, according to the concept of one day surgery. MATERIAL AND METHODS: Unicentric, retrospective analysis of patients with aorto-iliac aneurysmal disease, consecutively treated by EVAR with percutaneous access trough the Preclose technique (pEVAR), according to the outpatient criteria, with one overnight stay in the hospital...
June 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27858838/a-case-report-of-children-s-divergent-dislocation-of-the-elbow-and-review-of-literature
#12
Yongtao Wu, Hai Jiang, Wusheng Miao
BACKGROUND: The divergent dislocation of the elbow is not common in children, and the imaging is difficult and challenging. This often leads to misdiagnosis or inappropriate treatment. The literature has reported a total of 19 cases currently. METHODS: A 10-year-old girl with divergent dislocation of the elbow was admitted in our department in November 2013. When playing basketball, her right elbow was injured on the concrete floor. After injury, her right elbow joint became severely swollen, with obvious deformity...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27834002/feasibility-of-hysteroscopic-endometrial-polypectomy-using-a-new-dual-wavelengths-laser-system-dwls-preliminary-results-of-a-pilot-study
#13
Luigi Nappi, Felice Sorrentino, Stefano Angioni, Alessandro Pontis, Pietro Litta, Pantaleo Greco
PURPOSE: Currently, endometrial polyps may be successfully treated in an outpatient setting with 5 Fr mechanical and bipolar instruments. Our aim is to evaluate the benefits of minimally invasive techniques in hysteroscopy, focusing on the use of a new dual wavelengths laser system in the treatment of endometrial polyps in an outpatient setting. METHODS: Between September 2012 and December 2014, all consecutive patients of reproductive and menopausal age with ultrasound diagnosis of endometrial polyp with maximum diameter ≤2...
November 11, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27819645/supradentate-transmucosal-hemorrhoidopexy-original-technical-variant
#14
Ștefan Voiculescu, Elena Gabriela Voiculescu, Răzvan Scăunaşu, Cristian Bălălău
Symptomatic hemorhoidal disease is a serious issue affecting the quality of life. The multiplicity of current interventional procedures reflects the failure of covering all pathological aspects, thus justifying the quest for other operative solutions. Any new operative procedure is challenged by the need for broad applicability and less invasive attributes and should fit inside the frame of reasonable costs, fair efficacy, low morbidity and recurrence rate based on a procedural technique that is simple enough, reproducible and easy-tolearn...
2016: Chirurgia
https://www.readbyqxmd.com/read/27785096/an-electronic-surgical-order-undertaking-patient-education-and-obtaining-informed-consent-for-regional-analgesia-before-the-day-of-surgery-reduce-block-related-delays
#15
Brandon S Brooks, Joydip Barman, Brent A Ponce, Alisa Sides, Thomas R Vetter
BACKGROUND: Obtaining patient informed consent for a regional analgesia block on the day of surgery can result in surgical case delays. We hypothesized that implementing a preoperative electronic surgical order, undertaking patient education, and obtaining informed consent for a regional block in our preoperative assessment clinic prior to the day of surgery would reduce surgical case delays attributed to our regional anesthesia pain service and increase the percentage of patients for whom our regional anesthesia pain service was requested to provide a block...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27778056/-unilateral-spinal-anesthesia-literature-review-and-recommendations
#16
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27771095/transanal-hemorrhoid-dearterialization-is-a-safe-and-effective-outpatient-procedure-for-the-treatment-of-hemorrhoidal-disease
#17
Zoran Bjelanovic, Miroljub Draskovic, Milic Veljovic, Ivan Lekovic, Menelaos Karanikolas, Dusica Stamenkovic
INTRODUCTION: This prospective, observational study evaluated transanal dearterialization (THD) efficacy and safety in grade 2-4 hemorrhoids (HD). METHODS: THD was performed under sedation-locoregional anesthesia in 402 outpatients. Patients had follow-up evaluation 3 days, 2 weeks, 1, 6 and 12 months postoperatively. RESULTS: Mean patient age was 46.4 (range 20-85) years. A total of 268 patients (66.6%) were male. Sixteen patients (4.0%) had grade 2 HD, 210 (52...
October 19, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27766546/management-of-skin-cancer-in-the-high-risk-patient
#18
James W Behan, Adam Sutton, Ashley Wysong
Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression...
December 2016: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/27761589/-minimally-invasive-treatment-of-benign-prostatic-hyperplasia
#19
G Magistro, C G Stief, C Gratzke
Novel minimally invasive treatment options for the management of male lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO) aim to provide equal efficacy compared to standard techniques with a more favourable safety profile. The preservation of all aspects of male sexual function including antegrade ejaculation is increasingly important to patients. It should be ideally performed in an outpatient setting under local anesthesia to assure a short recovery time. Novel injectables for intraprostatic application (botulinum neurotoxin A, NX-1207, PRX302) have emerged and first phase III results could not confirm the promising initial data...
October 19, 2016: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/27753787/best-practices-for-outpatient-anterior-cervical-surgery-results-from-a-delphi-panel
#20
Anita Mohandas, Chris Summa, W Bradley Worthington, Jason Lerner, Kevin T Foley, Robert J Bohinski, Gregory B Lanford, Carol Holden, Richard N W Wohns
STUDY DESIGN: Delphi Panel expert panel consensus and narrative literature review OBJECTIVE.: To obtain expert consensus on best practices for patient selection and perioperative decision making for outpatient anterior cervical surgery (anterior cervical disc fusion (ACDF) and cervical total disc replacement (CTDR)). SUMMARY OF BACKGROUND DATA: Spine surgery in ambulatory settings is becoming a preferred option for both patients and providers. The transition from traditional inpatient environments has been enabled by innovation in anesthesia protocols and surgical technique, as well as favorable economics...
October 6, 2016: Spine
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