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Office anesthesia

Cristina Remondi, Francesco Sesti, Giuseppe Sorrenti, Giovannella Venezia, Roberto Sorge, Adalgisa Pietropolli, Beatrice Silvi, Emilio Piccione
OBJECTIVE: The aim of this study was to compare 22 Fr unipolar resectoscope with the traditional 26 Fr unipolar resectoscope in endometrial polypectomy performed under paracervical block anesthesia. METHODS: The trial took place in Gynecologic Unit, Department of Surgery, Tor Vergata University Hospital, Rome. Inclusion criteria were: diagnosis of endometrial polyps <3 cm at office hysteroscopy; agreement of patients to perform surgery under paracervical block anesthesia but not in office setting...
March 15, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Dennis DiGiorgi, John L Cerf, Daniel S Bowerman
Over a period of decades chiropractors have utilized spinal manipulation under anesthesia (SMUA) to treat chronic back and neck pain. As an advanced form of manual therapy, SMUA is reserved for the patient whose condition has proven refractory to office-based manipulation and other modes of conservative care. Historically, the protocols and guidelines put forth by chiropractic MUA proponents have served as the clinical compass for directing MUA practice. With many authors and MUA advocates having focused primarily on anticipated benefit, the published literature contains no resource dedicated to treatment precautions and contraindications...
2018: Chiropractic & Manual Therapies
Stewart L Cohen, Keira P Mason, Mark A Saxen
No abstract text is available yet for this article.
2018: Anesthesia Progress
Matthew R Zeiderman, Shahrooz Sean Kelishadi, John Paul Tutela, Arun Rao, Saeed Chowdhry, Ronald M Brooks, Bradon J Wilhelmi
Background: Minimally invasive cosmetic procedures are the most commonly performed aesthetic techniques by plastic surgeons. Patients are interested in a pain-free experience. Surgeons desire patient satisfaction and time-efficient utilization of office staff and resources. Clinical evidence exists for use of vapocoolant technology to reduce pain associated with intravenous cannulation in the pediatric population and in hemodialysis patients. Applying vapocoolant technology to facial rejuvenation is a novel approach to decrease pain associated with neurotoxin or filler injection...
2018: Eplasty
Stuart Lieblich
No abstract text is available yet for this article.
February 23, 2018: Journal of Oral and Maxillofacial Surgery
Ming Xiong, Nimisha Shiwalkar, Kavya Reddy, Peter Shin, Alex Bekker
Propofol is a short-acting intravenous anesthetic agent suitable for induction and maintenance of general anesthesia as well as for procedural and intensive care unit sedation. As such it has become an unparalleled anesthetic agent of choice in many institutional and office practices. However, in addition to its idealistic properties as an anesthetic agent, there is accumulating evidence suggesting its potential for abuse. Clinical and experimental evidence has revealed that not only does propofol have the potential to be abused, but also that addiction to propofol shows a high mortality rate...
February 22, 2018: Brain Sciences
Bonnie S Jones, Sara Daniel, Lindsay K Cloud
OBJECTIVES: To compare the prevalence and characteristics of facility laws governing abortion provision specifically (targeted regulation of abortion providers [TRAP] laws); office-based surgeries, procedures, sedation or anesthesia (office interventions) generally (OBS laws); and other procedures specifically. METHODS: We conducted cross-sectional legal assessments of state facility laws for office interventions in effect as of August 1, 2016. We coded characteristics for each law and compared characteristics across categories of laws...
February 22, 2018: American Journal of Public Health
Ross Pearlman, Steven R Feldman, Leah Cardwell, Katarina R Kesty
No abstract text is available yet for this article.
February 10, 2018: Journal of the American Academy of Dermatology
Rebecca J Howell, Melissa A Schopper, John Paul Giliberto, Ryan M Collar, Sid M Khosla
OBJECTIVE: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA). METHODS: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Next, a transnasal esophagoscopy (TNE) was performed. If the patient tolerated TNE, we proceeded with esophageal dilation using Seldinger technique with the CRE™ Boston Scientific (Boston Scientific Corp...
February 8, 2018: Laryngoscope
Alexa R Meyer, Gregory A Joice, Zeyad R Schwen, Alan W Partin, Mohamad E Allaf, Michael A Gorin
OBJECTIVE: To describe our procedural technique and initial outcomes performing in-office transperineal prostate biopsies using the PrecisionPoint Transperineal Access System. PATIENTS AND METHODS: Following Institutional Review Board approval, we retrospectively reviewed the records of men who underwent an in-office transperineal prostate biopsy using the PrecisionPoint device. Records were reviewed for baseline characteristics, biopsy results, and post-biopsy complications...
January 31, 2018: Urology
Marta Filauro, Alberto Paderno, Pietro Perotti, Filippo Marchi, Sabrina Garofolo, Giorgio Peretti, Cesare Piazza
OBJECTIVES/HYPOTHESIS: There is no general consensus on what kind of examination to include in an optimal detection strategy for head and neck squamous cell carcinomas of unknown primary (SCCUPs). This study investigates the role of narrow-band imaging (NBI) in their identification. STUDY DESIGN: Case series. METHODS: Twenty-nine consecutive patients affected by SCCUPs were referred at two academic institutions. Selection criteria were: 1) lymph node cytology positive for squamous cell carcinoma (SCC); 2) no evidence of any primary at white light (WL); 3) negative contrast-enhanced computed tomography (CT) and/or magnetic resonance imaging, and positron emission tomography-CT; and 4) no contraindication to general anesthesia...
February 2, 2018: Laryngoscope
Brianna K Crawley, Salem Dehom, Emily Kutzner, Thomas Murry, Priya Krishna, Justin Hata
OBJECTIVES/HYPOTHESIS: In-office laryngology procedures are important in the treatment of voice and swallowing disorders. Patient tolerance determines which procedures can be performed without sedation or formal anesthesia. This study examines pain perception during and after in-office vocal fold injection augmentation. STUDY DESIGN: Prospective cohort study. METHODS: Patients scheduled for office-based vocal fold injection augmentation were prospectively enrolled at an academic voice center...
January 22, 2018: Laryngoscope
Caitlin Bertelsen, Hagit Shoffel-Havakuk, Karla O'Dell, Michael M Johns, Lindsay S Reder
Importance: Endoscopic dilation is the mainstay treatment strategy for subglottic and proximal tracheal stenosis (SGS/PTS). Its major limitation is restenosis requiring repeated surgery. Intralesional steroid injection (ISI) is a promising adjunctive treatment aimed at prolonging the effects of dilation. Objective: To evaluate the association of serial in-office ISI after endoscopic dilation with surgery-free interval (SFI) in adults with SGS/PTS. Design, Setting, and Participants: A retrospective study of adults with SGS/PTS who underwent at least 2 consecutive in-office ISI at the University of Southern California, Keck School of Medicine, over a 3-year period was conducted...
January 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
Yong-Hee Park, Seho Lim, Hyun Kang, Hwa-Yong Shin, Chong Wha Baek, Young Cheol Woo
We measured noninvasive hemoglobin (SpHb) levels during the pre-anesthesia visit in patients planning elective surgery. Differences between SpHb and laboratory-measured hemoglobin (Hblab) were compared between adult and pediatric patients. In the pre-anesthesia visiting office, we routinely monitor noninvasive Hb levels with oxygen saturation and heart rate using Masimo Radical-7® Pulse CO-Oximetry (Masimo Corp., Irvine, CA, USA). We attached the R1 20 (body weight, 10-50 kg) or R1 25 (body weight > 30 kg) probe on the index finger...
January 4, 2018: Journal of Clinical Monitoring and Computing
Andrew J Ottaway, Leonard Kabongo
BACKGROUND: Access to safe surgery and anesthesia care is grossly inadequate in low- and middle-income countries, with a shortage of anesthesia providers contributing to this crisis. In Namibia, medical officers typically receive no >3 months of informal training in anesthesia. This study sought to determine the prevalence, currently unknown, of intraoperative adverse anesthetic events in this setting. Further, we assessed surgical volume, complications, and mortality outcomes at the district hospital level...
December 19, 2017: Anesthesia and Analgesia
David Tivey, Ning Ma, Joanna Duncan, Yasoba Atukorale, Robyn Lambert, Guy Maddern
BACKGROUND: There is growing trend for some surgical procedures previously performed in hospitals to be done in alternative settings, including office-based facilities. There has been some safety concerns reported in the media, which document serious adverse events following procedures performed in an office-based setting. To understand the current regulatory oversight of surgery in this setting ASERNIP-S conducted a review of the legislative and accreditation process governing these facilities in Australia...
January 2017: International Journal of Technology Assessment in Health Care
Angela M Mickle, Hannah R Maybrier, Anke C Winter, Sherry L McKinnon, Brian A Torres, Nan Lin, Eric J Lenze, Susan Stark, Maxwell R Muench, Eric Jacobsohn, Sharon K Inouye, Michael S Avidan, Troy S Wildes
BACKGROUND: Although the National Institutes of Health (NIH) invests $30 billion in research annually, many funded studies fail to generate results that can inform practice. The National Institutes of Health introduced a phased funding mechanism as one potential solution. Study-specific milestones are established for an initial pilot phase. We assess the utility of this phased approach through the ongoing Electroencephalography (EEG) Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) pragmatic clinical trial...
December 11, 2017: Anesthesia and Analgesia
Keira P Mason, Christopher M Burkle
Over the past few years, there has been a rapid rise in office-based procedures, out of hospital and day surgery procedures, particularly as an effort to combat the escalating costs of hospital- based services. Coincident with this burgeoning demand for office based anesthesia, is the accompanying increased risk of anesthesia and sedation-related complications. In the 1990's and 2000's, the risk of mortality was higher for anesthetics and sedations performed outside of the operating theater setting. Although guidelines exist for ambulatory and office based anesthesia, they are being continuously reviewed and reconsidered...
December 13, 2017: Minerva Anestesiologica
Gary J Nishioka
Transitioning of rhinologic procedures from the operating room to the office setting in selected patients is a rising trend. An effective pain-control, patient-preparation protocol is essential, especially with advanced in-office rhinologic procedures such as hybrid balloon sinus dilation (BSD), in which other procedures such as ethmoidectomy, turbinate reduction, and other procedures are concomitantly performed. A regimen using oral sedation, topical tetracaine gel, topical tetracaine/epinephrine-soaked cottonoid packs, and intranasal local infiltrative anesthesia can vary significantly in effectiveness and be suboptimal at times (as determined by using treated patients as historical controls)...
December 2017: Ear, Nose, & Throat Journal
Mark A Saxen
No abstract text is available yet for this article.
2017: Anesthesia Progress
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