By Peter S.A. Glass MD
This factor brings the anesthesiologist brand new on present crucial issues in ambulatory anesthesia. themes coated comprise obstructive sleep apnea, pediatric ambulatory anesthesia, supraglottic airway units, matters in office-based ambulatory anesthesia, advanced sedation, the position of local anesthesia within the ambulatory surroundings, neighborhood catheters, postoperative discomfort administration for the ambulatory sufferer, and updates on PONV and PDNV. Authors additionally discover the questions of ways a lot checking out might be performed, the best way to make your self ASC fascinating to sufferers and surgeons, and extra.
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Extra resources for Ambulatory Anesthesia, An Issue of Anesthesiology Clinics (The Clinics: Surgery)
8 Anesthesiologists are increasingly using a combination of nonopioid analgesic medications as the first line of therapy for the prevention of pain in the postoperative period. However, opioid analgesics will likely remain the primary treatment option for patients who require rescue analgesic therapy in the postoperative period until more potent and rapid-acting nonopioid analgesics become available for routine clinical use. In 2000, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) introduced new standards that mandated pain assessment and treatment as part of routine patient care in an attempt to improve control of acute pain.
In the authors’ opinion, patients with mild OSA would not require preoperative PAP therapy. Patients with mild OSA, without respiratory events in the PACU, may be managed with routine perioperative care. For all patients with known OSA, there should also be a focus on airway assessment, Mallampati scoring,35 and formulation of a perioperative management plan. Patient-specific comorbidities should be assessed and optimized. The anesthesiologist should engage the patient to explore the various anesthetic options and discuss patient-specific risks pertaining to OSA.
Preoperative and postoperative management of obstructive sleep apnea patients. Otolaryngol Clin North Am 2007;40:877–89. 26. Chung F, Elsaid H. Screening for obstructive sleep apnea before surgery: why is it important? Curr Opin Anaesthesiol 2009;22:405–11. 27. McNicholas WT, Ryan S. Obstructive sleep apnoea syndrome: translating science to clinical practice. Respirology 2006;11:136–44. 28. Hallowell PT, Stellato TA, Schuster M, et al. Potentially life-threatening sleep apnea is unrecognized without aggressive evaluation.