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Outpatient anesthesia

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https://www.readbyqxmd.com/read/29331574/a-medicare-cost-analysis-of-mri-versus-ct-based-high-dose-rate-brachytherapy-of-the-cervix-can-mri-based-planning-be-less-costly
#1
Amishi Bajaj, Grant Harmon, John Weaver, Brendan Martin, Michael Mysz, Murat Surucu, John C Roeske, Andre A Konski, William Small, Matthew M Harkenrider
PURPOSE: While some institutions deliver multiple fractions per implant for MRI-based planning, it is common for only one fraction to be delivered per implant with CT-based cervical brachytherapy. The purpose of this study was to compare physician costs, hospital costs, and overall costs for cervical cancer patients treated with either CT-based or MRI-based high-dose-rate (HDR) cervical brachytherapy to determine if MRI-based brachytherapy as described can be financially feasible. METHODS AND MATERIALS: We identified 40 consecutive patients treated with curative intent cervical brachytherapy...
January 10, 2018: Brachytherapy
https://www.readbyqxmd.com/read/29275894/ambulatory-surgery-under-local-anesthesia-for-parathyroid-adenoma-feasibility-and-outcome
#2
A Benhami, E Chuffart, N Christou, S Liva-Yonnet, M Mathonnet
The aim of this study was to evaluate the results of ambulatory parathyroid resection performed under local anesthesia (LA). MATERIAL AND METHODS: Outpatients undergoing parathyroid adenoma resection by a focused approach under LA were included. Results were evaluated by intraoperative serum parathormone levels (ioPTH) and the balance of phosphate and calcium postoperatively, at 3 months, 1 year and at the point date. The quality of ambulatory care was evaluated by the number of cancelled interventions, the number of patients hospitalized after surgery or during the first postoperative month...
December 21, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29243898/invasive-treatment-of-superficial-veins-of-the-lower-extremities
#3
Jukka Saarinen
Modern invasive treatment of superficial venous insufficiency of the lower extremities is largely based on the use of intravenous procedures under ultrasound guidance. The first-line treatment is thermoablation, in which the insufficient superficial vein, typically vena saphena magna or parva, is constricted by using laser or radio frequency energy under ultrasound guidance. The procedure is nearly always successful under local anesthesia and can be performed as an outpatient operation. When necessary, visible collateral varices can be treated with foam sclerotherapy or by surgical excision...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29229221/intravesical-electromotive-botulinum-toxin-type-a-administration-for-management-of-urinary-incontinence-secondary-to-neuropathic-detrusor-overactivity-in-children-long-term-follow-up
#4
Seyedeh-Sanam Ladi-Seyedian, Lida Sharifi-Rad, Abdol-Mohammad Kajbafzadeh
OBJECTIVES: To investigate the long-term efficacy and success rate of intravesical electromotive botulinum toxin type A (BoNTA) "Dysport®" administration in myelomeningocele (MMC) patients who had urinary incontinence due to neuropathic detrusor overactivity (NDO). METHODS: Twenty four MMC patients (mean age: 9± 3.6 years, range: 3-16) were included in the study and followed up for six years. Using an electrode bladder catheter, 10 IU/kg of Dysport® (BoNTA) was inserted into the bladder for electromotive drug administration (EMDA) without anesthesia on outpatient basis...
December 8, 2017: Urology
https://www.readbyqxmd.com/read/29224711/-risk-factors-associated-with-anesthesia-emergence-delirium-in-children-undergoing-outpatient-surgery
#5
Ana Carolina Tavares Paes Barreto, Ana Carolina Rangel da Rocha Paschoal, Carolina Barbosa Farias, Paulo Sérgio Gomes Nogueira Borges, Rebeca Gonelli Albanez da Cunha Andrade, Flávia Augusta de Orange
INTRODUCTION: Anesthesia emergence delirium (AED) is a self-limiting clinical phenomenon very common in children. Although pathophysiology is still uncertain, some factors seem to be involved, such as rapid awakening in an unknown environment, agitation during anesthetic induction, preoperative anxiety, environmental disorders, use of preanesthetic medication, use of inhalational anesthetics, and postoperative pain. OBJECTIVE: To determine the prevalence and risk factors associated with AED in children undergoing outpatient surgery...
December 7, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29218477/safety-and-efficacy-of-facial-fat-grafting-under-local-anesthesia
#6
Xiaorong Ma, Liming Wu, Tianxiang Ouyang, Wenjia Ge, Jingwen Ke
BACKGROUND: Facial fat grafting under local anesthesia has been widely performed in outpatient departments and private settings in China. The present study aimed to evaluate the safety and efficacy of facial fat grafting under local anesthesia. METHOD: A retrospective study was conducted on 155 patients who underwent facial fat grafting. The clinical data were recorded. Preoperative and postoperative two-dimensional images were acquired to evaluate the effect of facial fat grafting on refining facial contouring, rejuvenation as well as deformity reconstruction...
December 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29206787/outpatient-total-knee-arthroplasty-is-associated-with-higher-risk-of-perioperative-complications
#7
Armin Arshi, Natalie L Leong, Anthony D'Oro, Christopher Wang, Zorica Buser, Jeffrey C Wang, Kristofer J Jones, Frank A Petrigliano, Nelson F SooHoo
BACKGROUND: As concerns regarding health-care expenditure in the U.S. remain at the national forefront, outpatient arthroplasty is an appealing option for carefully selected patient populations. The purpose of this study was to determine the nationwide trends and complication rates associated with outpatient total knee arthroplasty (TKA) in comparison with standard inpatient TKA. METHODS: We performed a retrospective review of the Humana subset of the PearlDiver Patient Record Database to identify patients who had undergone TKA (Current Procedural Terminology [CPT] code 27447) as either outpatients or inpatients from 2007 to 2015...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29201423/patient-satisfaction-and-wait-times-following-outpatient-manual-vacuum-aspiration-compared-to-electric-vacuum-aspiration-in-the-operating-room-a-cross-sectional-study
#8
Laura E Dodge, Lisa G Hofler, Michele R Hacker, Sadia Haider
Background: Outpatient manual vacuum aspiration (MVA) is a safe and equally effective alternative to electric vacuum aspiration (EVA) in the operating room. This project was conducted to determine whether outpatient MVA expedites care while maintaining patient satisfaction. Methods: A cross-sectional study of a convenience sample of patients undergoing surgical management of spontaneous abortion, induced abortion, or retained products of conception with either outpatient MVA under local anesthesia or EVA in the operating room was conducted...
2017: Contraception and Reproductive Medicine
https://www.readbyqxmd.com/read/29200375/a-case-of-laryngeal-granuloma-likely-caused-by-laryngopharyngeal-reflux-disease-following-a-sagittal-split-ramus-osteotomy
#9
Mami Nakamura, Akio Uda, Naokazu Kataoka, Kana Nagasaka, Kazuhisa Tamashige, Daichi Mori, Hideo Niwa, Koh Shibutani
Laryngeal granuloma is an uncommon complication of prolonged endotracheal intubation. A 25-year-old woman with severe jaw deformity underwent sagittal split ramus osteotomy under general anesthesia. Two days after extubation, the patient complained of hoarseness, sore throat, and dyspnea. When symptoms persisted, she was evaluated in the Otolaryngology Department. She was diagnosed with laryngeal granuloma of the bilateral arytenoid cartilages, and conservative treatment was selected. Administration of corticosteroid hormones, proton pump inhibitors, and a subsequent follow-up examination performed in our outpatient clinic showed no evidence of recurrence 10 months after the initial presentation...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29200071/evidence-basis-for-regional-anesthesia-in-ambulatory-anterior-cruciate-ligament-reconstruction-part-iii-local-instillation-analgesia-a-systematic-review-and-meta-analysis
#10
Eric M Yung, Richard Brull, Eric Albrecht, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and meta-analysis evaluates the analgesic benefits of LIA for outpatient ACLR. METHODS: We sought randomized controlled trials investigating the analgesic effects of LIA versus control in adults having outpatient ACLR and receiving multimodal analgesia (excluding nerve blocks, which are examined in parts I and II of this project)...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29175752/lack-of-generalizability-of-observational-studies-findings-for-turnover-time-reduction-and-growth-in-surgery-based-on-the-state-of-iowa-where-from-one-year-to-the-next-most-growth-was-attributable-to-surgeons-performing-only-a-few-cases-per-week
#11
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads. DESIGN: Observational cohort study. SETTING: 116 hospitals in Iowa with inpatient or outpatient surgery from July 1, 2013 through June 30, 2015...
November 23, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29172414/contraception-update-sterilization
#12
Karen Antell, Prium Deshmukh, Elizabeth J Brown
Female sterilization procedures include postpartum partial salpingectomy via cesarean or minilaparotomy incision, interval laparoscopic procedures, or hysteroscopic placement of microinserts. Rates of failure and serious complications are low and comparable among the various methods. A hysteroscopic procedure requires a 3-month confirmatory hysterosalpingogram before it is considered effective for contraception. Hysteroscopic sterilization has been shown to be associated with a higher reoperation rate than laparoscopic procedures...
November 2017: FP Essentials
https://www.readbyqxmd.com/read/29160727/a-review-of-perioperative-complications-of-outpatient-total-ankle-arthroplasty
#13
Todd R Borenstein, Kapil Anand, Quanlin Li, Timothy P Charlton, David B Thordarson
BACKGROUND: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. Outpatient TAA are increasingly common and have been shown to decrease costs compared to inpatient surgery. However, there are very few studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive patients who received outpatient TAA to identify complication rates. METHODS: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum 6-month follow-up were reviewed...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29159751/septal-and-turbinate-surgery-is-overnight-essential
#14
Ana Sousa Menezes, Joana R Guimarães, Miguel Breda, Vicente Vieira, Luís Dias
INTRODUCTION: The performance of septoplasty and turbinate surgery in an outpatient basis is an increasingly established practice, although is still a controversial topic. METHODS: Retrospective analysis of 227 patients who underwent septoplasty ± inferior and/or middle turbinoplasty. Demographic, clinical, surgical, and anesthetic data were collected. Our primary outcomes were rates of perioperative complications, prolongation of hospital stay (PHS), unexpected hospital revisits (UHR), or readmissions within 30 days of surgery...
November 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29158935/synchronous-hpv-related-cancer-of-bilateral-tonsils-detected-using-transoral-endoscopic-examination-with-narrow-band-imaging
#15
Fukuko Shimizu, Kenji Okami, Koji Ebisumoto, Daisuke Maki, Akihiro Sakai, Go Ogura, Naoya Nakamura, Masahiro Iida
Background: The incidence of human papillomavirus- (HPV-) related oropharyngeal squamous cell carcinoma (OPSCC) has been rapidly increasing worldwide. HPV is reported in approximately 50% cases of OPSCC in Japan. However, there are few reports of synchronous bilateral HPV-positive tonsillar carcinoma, and, in almost all those cases, carcinoma was detected using positron emission tomography/computed tomography and/or bilateral tonsillectomy. Methods and Results: We report the case of a 63-year-old male with bilateral tonsillar carcinoma detected using transoral endoscopic examination with narrow-band imaging (NBI)...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29155341/outpatient-elective-posterior-lumbar-fusions-appear-to-be-safely-considered-for-appropriately-selected-patients
#16
Patawut Bovonratwet, Taylor D Ottesen, Raj J Gala, Daniel R Rubio, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
BACKGROUND CONTEXT: There has been growing interest in performing posterior lumbar fusions (PLFs) in the outpatient setting to optimize patient satisfaction and reduce cost. Although still done in only a small percentage of cases, this has been more possible because of advances in surgical techniques and anesthesia. However, data on the perioperative course of outpatient compared with inpatient PLF in a large sample size are scarce. PURPOSE: This study aimed to compare perioperative complications between outpatient and inpatient PLF in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a%C3%A2-randomized-controlled-trial
#17
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment, in premenopausal women who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists, and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: The aim of this study was to evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29145987/outpatient-total-knee-arthroplasty-are-we-there-yet-part-2
#18
REVIEW
Andrew Krause, Zain Sayeed, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The method by which surgeons conduct outpatient total knee procedures has yet to be fully elucidated. Literature demonstrates different experiences from various care protocols in place across the nation. This article reviews current recommendations for implementing successful total knee arthroplasty (TKA) and unicompartmental knee arthroplasty outpatient protocols. Specifically, information regarding anesthesia and analgesia modalities, perioperative care, operative technique, and postoperative care within outpatient TKA pathways is discussed...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145985/use-of-wide-awake-local-anesthesia-no-tourniquet-in-hand-and-wrist-surgery
#19
REVIEW
Murphy M Steiner, James H Calandruccio
WALANT (wide-awake local anesthesia no tourniquet) appears to be a safe and effective anesthesia technique for many hand and wrist surgeries. Patient satisfaction is high because of the avoidance of preoperative testing and hospital admission. Postoperative recovery is rapid, and procedures can be done in outpatient settings, resulting in substantial savings in time and money.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145981/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-2
#20
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The intra- and postoperative phases of outpatient total hip arthroplasty (THA) vary by institution and surgeon. An understanding of an evidence-based approach to enhancing the intra- and postoperative phases of the care continuum is warranted to offer high-value care to outpatient candidates. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding anesthesia and analgesia modalities, intraoperative considerations, and postoperative rehabilitation amenable to outpatient THA...
January 2018: Orthopedic Clinics of North America
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