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Office anesthesia

B Peyronnet, S-J Drouin, F-D Gomez, T Seisen, A Goujon, B Pradere, M-O Bitker, V Phé, M Rouprêt
INTRODUCTION: Local anesthesia using urethral gel has been proven to reduce discomfort of male patients during flexible cystoscopy. This study was a non-inferiority study between two lidocain-containing urethral gel (Instillagel(®) Lido and Xylocaine(®) gel). METHODS: A prospective single center study was conducted between June 2014 and November 2014. Male patients seen in the office and in whom a flexible cystoscopy was planned were included in the present study and received urethral instillation of either Xylocaine(®) gel or Instillagel(®) Lido at least 5minutes before flexible cystoscopy...
October 3, 2016: Progrès en Urologie
David W Polly, Stacey J Ackerman, Karen Schneider, Jeff B Pawelek, Behrooz A Akbarnia
PURPOSE: Traditional growing rod (TGR) for early-onset scoliosis (EOS) is effective but requires repeated invasive surgical lengthenings under general anesthesia. Magnetically controlled growing rod (MCGR) is lengthened noninvasively using a hand-held magnetic external remote controller in a physician office; however, the MCGR implant is expensive, and the cumulative cost savings have not been well studied. We compared direct medical costs of MCGR and TGR for EOS from the US integrated health care delivery system perspective...
2016: ClinicoEconomics and Outcomes Research: CEOR
Anni Koskinen, Petri Mattila, Jyri Myller, Matti Penttilä, Juha Silvola, Ismo Alastalo, Heini Huhtala, Maija Hytönen, Sanna Toppila-Salmi
CONCLUSION: In terms of operation time, anesthesia method, and low complication rate, ESS and balloon sinuplasty seemed comparable. The advantages of balloon sinuplasty were shown to be shortness of sick leave, possibility to be performed as an in-office procedure, and lower adhesion formation. BACKGROUND: Endoscopic sinus surgery (ESS) has been considered as a treatment of choice for persistent chronic rhinosinusitis (CRS). During the last decade balloon sinuplasty has been introduced as an alternative technique to dilate the ostium...
September 20, 2016: Acta Oto-laryngologica
Thomas F Burke, Brett D Nelson, Taylor Kandler, Zaid Altawil, Khama Rogo, Javan Imbamba, Stella Odenyo, Leeya Pinder, Svjetlana Lozo, Moytrayee Guha, Melody J Eckardt
OBJECTIVE: To assess the safety of a ketamine-based rescue anesthesia package to support emergency cesarean delivery and emergency laparotomy when no anesthetist was available. METHODS: A prospective case-series study was conducted at seven sub-county hospitals in western Kenya between December 10, 2013, and January 20, 2016. Non-anesthetist clinicians underwent 5days of training in the Every Second Matters-Ketamine (ESM-Ketamine) program. A database captured preoperative, intraoperative, and postoperative details of all surgeries in which ESM-Ketamine was used...
August 26, 2016: International Journal of Gynaecology and Obstetrics
Susan F Wilson, Elizabeth P Gurney, Mary D Sammel, Courtney A Schreiber
BACKGROUND: Women undergoing office-based surgical management of a failed or undesired pregnancy often report fear of pain and anxiety pertaining to the procedure. Doulas are trained to specifically address women's physical and emotional needs in obstetric care, and recently have extended their practice to support women through all pregnancy outcomes. OBJECTIVE: We sought to evaluate the impact of doulas on patients' physical and emotional responses to surgical management of a first-trimester failed or undesired pregnancy under local anesthesia...
September 6, 2016: American Journal of Obstetrics and Gynecology
Raymond A Dionne
Recently proposed revisions to the American Dental Association's Guidelines for the Use of Sedation and General Anesthesia by Dentists, aimed at improving safety in dental offices, differentiate between levels of sedation based on drug-induced changes in physiologic and behavioral states. However, the author of this op-ed is concerned the proposed revisions may have far-reaching and unintended consequences.
September 2016: Compendium of Continuing Education in Dentistry
Shlomo B Cohen, Jerome Bouaziz, Ariella Jakobson-Setton, Motti Goldenberg, Eyal Schiff, Raoul Orvieto, Adrian Shulman
OBJECTIVE: Investigate a novel office hysteroscopic tubal catheterization therapeutic method for proximal tubal occlusion. STUDY DESIGN: Prospective cohort study in a tertiary referral center. We evaluated the procedure on a group of 27 patients that were referred to our unit for proximal tubal occlusion demonstrated by hysterosalpingography, 9 (33.3%) of them with primary infertility and 18 of them (66.6%) with secondary infertility. The intervention included the usage of the modified Novy cornual cannulation set which was inserted through a 5F working cannel during an office operative hysteroscopy, followed by fallopian tube irrigation with saline-air mixture under ultrasonographic imaging...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Paul S Pagel
OBJECTIVE: The American Board of Anesthesiology (ABA) has been responsible for certification of anesthesiologists since 1938. Selected ABA diplomates provide their expertise to write the ABA's written and oral examinations and to administer the oral examination required for primary certification. The demographics, administrative and educational duties, and scholarly productivity of ABA volunteers and their dependence on subspecialty certification, transesophageal echocardiography (TEE) credentials, and grant funding are unknown...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
F J Bianco, J I Martínez-Salamanca
FocalyxTM conceived as a response to emerging evidence data across numerous cancer lesions that questions current standard treatment approaches that too often lead to detrimental quality of life yet delivering limited survival benefit, especially in-lieu of advances in imaging technology applicable to cancer patients. The Focalyx paradigm aims to control cancer with improvement in quality of life. We initially devised 5 milestones: 1- Consistently optimize Prostate MRI imaging using the novel published protocols adopted as guidelines by societies such as the European Society of Urology and Radiology; 2- Evaluate fusion platform software solutions that existed; 3- Determine best fusión platform for Focalyx on practicality, precision, and workflow premises; 4- Evaluate commercially available FDA approved ablative technologies to implement our treatment vision; 5- Design a treatment option that can be performed in the office setting under local anesthesia, which would not impact negatively QOL outcomes of Prostate Cancer patients and seamless constant nonintrusive practical patient-physician interaction by the Focalyx app that facilitates follow up and provides early warning signals shall any change in the disease dynamics emerge...
July 2016: Archivos Españoles de Urología
Pierluigi Giampaolino, Ilaria Morra, Giovanni Antonio Tommaselli, Costantino Di Carlo, Carmine Nappi, Giuseppe Bifulco
PURPOSE: To compare conventional laparoscopic ovarian drilling (LOD) with transvaginal hydrolaparoscopy (THL) ovarian drilling in terms of ovarian adhesion formation, evaluated using office THL during follow-up in CC-resistant anovulatory patients affected by PCOS. METHODS: Prospective randomized study on 246 CC-resistant women with PCOS. The patients enrolled were divided into two groups, 123 were scheduled to undergo LOD and 123 to undergo THL ovarian drilling...
October 2016: Archives of Gynecology and Obstetrics
Diego Marcelo May
PURPOSE OF REVIEW: Outpatient plastic surgery is growing around the world. This industry faces unique challenges in terms of patient selection and standards of practice to ensure safety and cost-effectiveness. This review will highlight information about anesthesia practice for outpatient cosmetic surgery in Brazil, especially regarding regulation, legislation, and medical tourism. RECENT FINDINGS: Medical tourism is growing worldwide, with a flow of patients traveling from developed to developing countries where procedures can be done at a fraction of the cost as in the patient's home country...
August 2016: Current Opinion in Anaesthesiology
Gonul Erden, Seyda Ozdemir, Gulfer Ozturk, Aydin Erden, Duygu Kara, Serhat Isik, Jülide Ergil, Cagil Vural, A Ercan Arzuhal
BACKGROUND: Vitamin D deficiency or insufficiency is a highly prevalent condition worldwide. Anesthesia providers or support personnel working in operating rooms might be considered at increased risk of vitamin D deficiency. There is a small amount of information about 25(OH)D levels in people who work mainly indoors as an operating room. This study aimed to investigate whether there was a higher vitamin D insufficiency or deficiency rate among anesthesia personnel working indoors when compared with personnel working in an office or outdoors in Ankara, Turkey (39 degrees North, 32 degrees East)...
2016: Clinical Laboratory
Jongyeop Park, Hochang Kim
This article is to introduce office-based endoscopic revision surgery using a microdebrider for failed endoscopic dacryocystorhinostomy (EN-DCR). The authors conducted retrospective, non-comparative, interventional case series analysis of 27 eyes of 24 patients, treated by office-based revision EN-DCR using a microdebrider. After local anesthesia, anatomical failures (cicatrization, granuloma, synechia) after primary EN-DCR were treated with a microdebrider (Osseoduo 120, Bien-Air Surgery, Le Noirmont, Switzerland) in an office setting, and a bicanalicular silicone tube was placed...
June 24, 2016: European Archives of Oto-rhino-laryngology
Spencer C Payne, Pablo Stolovitzky, Neelesh Mehendale, Keith Matheny, William Brown, Anthony Rieder, Douglas Liepert, Ewen Tseng, Andrew Gould, Scott Powell, Daniel Van Himbergen, Boris Karanfilov, Daniel Harfe, Laura England, Christopher Melroy
BACKGROUND: Although previous studies of sinus surgery that used balloon catheter dilation technology for the paranasal sinuses (balloon sinus dilation [BSD]) demonstrated safety and efficacy, data that compare BSD with continued medical management (MM) are lacking. OBJECTIVE: To evaluate the outcomes of sinus surgery when using BSD instruments versus MM for patients with chronic rhinosinusitis for whom MM failed. METHODS: Adult patients with chronic rhinosinusitis for whom a minimum of 3 weeks of oral antibiotics, 4 weeks of daily saline solution therapy, and 4 weeks of daily nasal corticosteroids failed were included...
July 2016: American Journal of Rhinology & Allergy
Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Enrico Ascher
OBJECTIVE: There is an increasing number of procedures that traditionally were performed in the inpatient setting that are now becoming office-based procedures. These include peripheral endovascular procedures such as angiograms, angioplasties, dialysis access interventions, and treatment for venous insufficiency. We chose to evaluate the feasibility, safety of inferior vena cava (IVC) filter placement in the office-based setting. METHODS: All procedures were performed using local anesthesia, and ultrasound guidance for puncture...
July 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Eelam A Adil, Kosuke Kawai, Natasha Dombrowski, Alexandria L Irace, Michael J Cunningham
OBJECTIVES/HYPOTHESIS: To systematically review the literature regarding the efficacy of different biopsy sites and methods to obtain an adequate ciliary sample for ultrastructural examination with electron microscopy (EM) for the diagnosis of primary ciliary dyskinesia (PCD). STUDY DESIGN: Systematic review and meta-analysis. METHODS: A literature search was conducted with respect to the diagnosis of PCD. English studies with five or more subjects were included...
June 16, 2016: Laryngoscope
Nahid Ramazani
CONTEXT: Most child population is able to undergo dental treatment in the conventional setting. However, some children fail to cope with in-office conscious state and cannot respond to usual management modalities. This review aims to discuss the topic further. EVIDENCE ACQUISITION: A computerized search in databases PubMed, MEDLINE, EMBASE, Google Scholar and Google were performed using dental general anesthesia related keywords. Original and review English-written articles that were limited to child population were retrieved without any limitation of publication date...
April 2016: Iranian Journal of Pediatrics
Usha Shukla, Tallamraju Prabhakar, Kiran Malhotra, Dheeraj Srivastava
BACKGROUND AND AIMS: Trials are being carried out to identify an adjuvant to intrathecal bupivacaine that preferably potentiates postoperative analgesia. This prospective, randomized, double-blind study was aimed to compare the onset and duration of sensory and motor block, postoperative analgesia and adverse effects of dexmedetomidine or midazolam given with 0.5% hyperbaric bupivacaine for spinal anesthesia. MATERIAL AND METHODS: A total of 80 patients, scheduled for vaginal hysterectomies, were randomly allocated to Group D (n = 40) to receive intrathecally 3...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Kevin M Motz, Alexander T Hillel
This review will highlight the indications and benefits of office-based therapy for recurrent respiratory papillomatosis (RRP) and discuss the utilization of photo-dynamic lasers and adjuvant medical therapy in office-based settings. Office-based management of RRP allows for more timely interventions, is preferred by the majority of patients, and negates the risk of general anesthesia. Current literature argues for the utilization of KTP laser over CO2 laser for office-based treatment of RRP. Medical therapies for RRP are limited, but agents such as bevacizumab are promising and have been shown to reduce disease burden...
June 2016: Current Otorhinolaryngology Reports
Bioku Muftau Jimoh, Ikuerowo Stephen Odunayo, Igwilo Chinwe, Omisanjo Olufunmilade Akinfolarin, Adewumi Oluwafemi, Esho Julius Olusanmi
INTRODUCTION: The World Health Organization's manual on male circumcision listed Plastibell technique as a well-proven paediatric method with respect to the results and complications. Although, literatures abound on its wide acceptability, there are few multi-centered reports from this environment. The objective was to evaluate the cases of infant circumcision by Plastibell device from two medical institutions. METHODS: All consecutive infants who had Classical Plastibell Circumcision (PC) at the Federal Staff Medical Centre, Abuja and the Lagos State University Teaching Hospital, Ikeja between February 2011 and June 2015 were included in this cross-sectional study...
2016: Pan African Medical Journal
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