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Ambulatory surgery anesthesia

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https://www.readbyqxmd.com/read/27890061/preoperative-screening-for-sleep-disordered-breathing-in-children-a-systematic-literature-review
#1
Erin E Bauer, Rebecca Lee, Yasmine N Campbell
Clinicians frequently underestimate or do not assess sleep-disordered breathing (SDB) in children in ambulatory surgical centers. Identifying the disorder and obtaining information relevant to anesthesia management can be assisted by the use of a standard questionnaire during preoperative assessment. We wanted to determine whether a preoperative screening tool increases clinician awareness of SDB in children and leads to a decrease in perioperative respiratory adverse events. We reviewed 21 articles to identify reliable screening tools for pediatric SDB in ambulatory surgical centers and selected six articles for the review...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#2
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871557/effect-of-adjunctive-dexmedetomidine-on-postoperative-intravenous-opioid-administration-in-patients-undergoing-thyroidectomy-in-an-ambulatory-setting
#3
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/27871514/cost-impact-of-unexpected-disposition-after-orthopedic-ambulatory-surgery-associated-with-category-of-anesthesia-provider
#4
Robert L Ohsfeldt, Thomas R Miller, John E Schneider, Cara M Scheibling
STUDY OBJECTIVE: To provide estimates of the costs and health outcomes implications of the excess risk of unexpected disposition for nurse anesthetist (NA) procedures. DESIGN: A projection model was used to apply estimates of costs and health outcomes associated with the excess risk of unexpected disposition for NAs reported in a recent study. SETTING: Ambulatory and inpatient surgery. PATIENTS: Base-case model parameters were based on estimates taken from peer-reviewed publications when available, or from other sources including data for all hospital stays in the United States in 2013 from the Healthcare Cost and Utilization Project Web site...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870808/description-and-results-of-a-comprehensive-care-protocol-for-overnight-stay-spine-surgery-in-adults
#5
Drew A Bednar
STUDY DESIGN: This is a prospective cohort study. OBJECTIVE: To define the probability of successful morning-after discharge after adult spine surgery achieved with a standard care protocol as applied to patients with a large variety of common degenerative spine disorders. SUMMARY OF BACKGROUND DATA: Qualifying criteria for ambulatory or overnight-stay adult spine surgery are not well defined in either the spine or anesthesia literature. Most reports simply go to ASA risk classification or surgical technique alternatives and do not present a clearly defined patient care and case management protocol...
November 18, 2016: Spine
https://www.readbyqxmd.com/read/27865327/indwelling-pleural-catheters-a-clinical-option-in-trapped-lung
#6
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/27861435/intramuscular-fentanyl-and-ketorolac-associated-with-superior-pain-control-after-pediatric-bilateral-myringotomy-and-tube-placement-surgery-a-retrospective-cohort-study
#7
Paul A Stricker, Wallis T Muhly, Ellen C Jantzen, Yue Li, Abbas F Jawad, Alexander S Long, Marcia Polansky, Scott D Cook-Sather
BACKGROUND: Bilateral myringotomy and pressure equalization tube insertion (BMT) is the most common surgery in children. Multiple anesthetic techniques for BMT have been proposed, but that which reliably promotes ideal recovery remains unclear. We sought to assess associations between anesthetic regimens that included single-agent (fentanyl or ketorolac) or dual-agent (fentanyl and ketorolac) analgesic therapy and the primary outcome of maximal postanesthesia care unit (PACU) pain score...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27852723/regional-versus-general-anesthesia-for-promoting-independence-after-hip-fracture-regain-protocol-for-a-pragmatic-international-multicentre-trial
#8
Mark D Neuman, Susan S Ellenberg, Frederick E Sieber, Jay S Magaziner, Rui Feng, Jeffrey L Carson
INTRODUCTION: Hip fractures occur 1.6 million times each year worldwide, with substantial associated mortality and losses of independence. At present, anaesthesia care for hip fracture surgery varies widely within and between countries, with general anaesthesia and spinal anaesthesia representing the 2 most common approaches. Limited randomised evidence exists regarding potential short-term or long-term differences in outcomes between patients receiving spinal or general anaesthesia for hip fracture surgery...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27829428/aromatherapy-for-the-treatment-of-ponv-in-children-a-pilot-rct
#9
Mathew B Kiberd, Suzanne K Clarke, Jill Chorney, Brandon d'Eon, Stuart Wright
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications of general anesthesia in pediatrics. Aromatherapy has been shown to be effective in treating PONV in adults. Given the encouraging results of the adult studies, we planned to determine feasibility of doing a large-scale study in the pediatric population. METHODS: Our group conducted a pilot randomized controlled trial examining the effect of aromatherapy on post-operative nausea and vomiting in patients 4-16 undergoing ambulatory surgery at a single center...
November 9, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27820738/an-update-on-pain-management-for-elderly-patients-undergoing-ambulatory-surgery
#10
Xuezhao Cao, Ofelia L Elvir-Lazo, Paul F White, Roya Yumul, Jun Tang
PURPOSE OF REVIEW: The aim of this review is to provide an overview of the drugs and techniques used for multimodal postoperative pain management in the older population undergoing surgery in the ambulatory setting. RECENT FINDINGS: Interest has grown in the possibility of adding adjuncts to a single shot nerve block in order to prolong the local anesthetic effect. The rapid and short-acting local anesthetics for spinal anesthesia are potentially beneficial for day-case surgery in the older population because of shorter duration of the motor block, faster recovery, and less transient neurologic symptoms...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27813384/medium-term-results-of-mini-arc-for-urinary-stress-incontinence-in-ambulatory-patients-under-local-anesthesia
#11
Almog Levi, Rasha Nasra, Inbar Ben Shachar, Naama Marcus Braun
OBJECTIVE: To evaluate the medium-term outcome and patient's satisfaction after Single-incision mini-sling (SIMS) procedure done under local anesthesia in ambulatory set up for patients with stress urinary incontinence (SUI). MATERIALS AND METHODS: This is a retrospective cohort study, including all patients submitted to SIMS procedure for SUI with MiniArc (AMS, U.S.A) without concomitant surgery between January 2011 and March 2013. Patients were followed up during 12 months after surgery and once a year subsequently...
November 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27811597/predictors-of-at-home-arterial-oxygen-desaturation-events-in-ambulatory-surgical-patients
#12
Chuck Biddle, Charles Elam, Laura Lahaye, Gordon Kerr, Laura Chubb, Brad Verhulst
OBJECTIVES: Little is known about the early recovery phase occurring at-home after anesthesia and surgery in ambulatory surgical patients. We studied quantitative oximetry and quality-of-life metrics in the first 48 hours after same-day orthopedic surgery examining the association between the recovery metrics and specific patient and procedural factors. METHODS: We used the STOP-Bang score to quantify patient risk for obstructive sleep apnea in 50 adult patients at 2 centers using continuous portable oximetry and patient journaling...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27796041/optimal-anesthetic-regimen-for-ambulatory-laser-microlaryngeal-surgery
#13
Hyub Huh, Seol Ju Park, Hyong Hwan Lim, Kwang Yoon Jung, Seung-Kuk Baek, Seung Zhoo Yoon, Hye Won Lee, Hye Ja Lim, Jang Eun Cho
OBJECTIVES/HYPOTHESIS: Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27792057/cost-savings-from-utilization-of-an-ambulatory-surgery-center-for-orthopaedic-day-surgery
#14
Peter D Fabricant, Mark A Seeley, Joshua C Rozell, Evan Fieldston, John M Flynn, Lawrence M Wells, Theodore J Ganley
INTRODUCTION: Healthcare providers are increasingly searching for ways to provide cost-efficient, high-quality care. Previous studies on evaluating cost used estimated cost-to-charge ratios, which are inherently inaccurate. The purpose of this study was to quantify actual direct cost savings from performing pediatric orthopaedic sports day surgery at an ambulatory surgery center (ASC) compared with a university-based children's hospital (UH). METHODS: Custom-scripted accounting software was queried for line-item costs for a period of 3 fiscal years (fiscal year 2012 to fiscal year 2014) for eight day surgery procedures at both a UH and a hospital-owned ASC...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27781372/sufentanil-sublingual-tablet-30-mcg-for-the-management-of-pain-following-abdominal-surgery-a-randomized-placebo-controlled-phase-3-study
#15
Harold S Minkowitz, David Leiman, Timothy Melson, Neil Singla, Karen DiDonato, Pamela P Palmer
BACKGROUND: Results from a phase-3, prospective, randomized, double-blind, placebo-controlled trial evaluating sufentanil sublingual tablet 30 mcg (SST) for the management of pain after ambulatory abdominal surgery are presented. METHODS: Adults with American Society of Anesthesiologists status 1 - 3 scheduled to undergo abdominoplasty, open tension-free inguinal hernioplasty, or laparoscopic abdominal surgery under general or spinal anesthesia that did not include intrathecal opioids during the operation were eligible...
October 26, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27760806/short-term-results-of-isolated-phlebectomy-with-preservation-of-incompetent-great-saphenous-vein-asval-procedure-in-primary-varicose-veins-disease
#16
Igor A Zolotukhin, Evgeny I Seliverstov, Elena A Zakharova, Alexander I Kirienko
OBJECTIVE: To establish an effect of isolated phlebectomy in patients with incompetent great saphenous vein (Ambulatory Selective Varices Ablation under Local anesthesia (ASVAL) procedure) on the reflux and diameter of the trunk and to assess recurrence rate of varicose veins at one year. MATERIAL AND METHODS: We conducted a prospective study on patients with primary varicose veins and with C2 or C2,3 or C2,3,4 or C2,4 classes of chronic venous disease and great saphenous vein incompetence...
October 19, 2016: Phlebology
https://www.readbyqxmd.com/read/27753787/best-practices-for-outpatient-anterior-cervical-surgery-results-from-a-delphi-panel
#17
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
https://www.readbyqxmd.com/read/27748668/assessing-the-value-of-risk-indices-of-postoperative-nausea-and-vomiting-in-ambulatory-surgical-patients
#18
Sofia Geralemou, Tong J Gan
PURPOSE OF REVIEW: Postoperative and postdischarge nausea and vomiting have profound impact on the efficient delivery of quality healthcare. In addition to patient dissatisfaction, physical morbidities as well as unplanned hospital admissions may result. It is important to risk stratify and intervene on patients at risk. The aim of this review is to explore the benefits and shortcomings of the scoring systems commonly used today. RECENT FINDINGS: Two widely-used risk stratification systems identify and score patient-, anesthesia-, and surgery-related risk factors for postoperative/postdischarge nausea and vomiting in the adult population...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27746521/postoperative-nausea-and-vomiting-a-simple-yet-complex-problem
#19
Safiya Imtiaz Shaikh, D Nagarekha, Ganapati Hegade, M Marutheesh
Postoperative nausea and vomiting (PONV) is one of the complex and significant problems in anesthesia practice, with growing trend toward ambulatory and day care surgeries. This review focuses on pathophysiology, pharmacological prophylaxis, and rescue therapy for PONV. We searched the Medline and PubMed database for articles published in English from 1991 to 2014 while writing this review using "postoperative nausea and vomiting, PONV, nausea-vomiting, PONV prophylaxis, and rescue" as keywords. PONV is influenced by multiple factors which are related to the patient, surgery, and pre-, intra-, and post-operative anesthesia factors...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27687425/using-an-at-risk-salary-model-to-improve-throughput-in-academic-medical-center-operating-rooms
#20
Rachel M Kacmar, Brian M Davidson, Matthew Victor, Ken Bullard, Jose Melendez
STUDY OBJECTIVE: The objective was to analyze if an at-risk salary model for faculty anesthesiologists could improve on-time first case starts (FCSs) and case turnovers (TOs) in an academic hospital inpatient operating room (IOR) and ambulatory surgery center (ASC). Organizational goals were 65% and 70% on-time FCS and case TO times for IOR and ASC, respectively. DESIGN: This was a retrospective study. SETTING: Surgical cases performed at both the IORs and the ASCs at a large academic medical center were included...
November 2016: Journal of Clinical Anesthesia
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