Anesthesia and analgesia
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Anesthesia and analgesia · Nov 1982
Criteria for selection of ambulatory surgical patients and guidelines for anesthetic management: a retrospective study of 1553 cases.
The charts of 1553 patients who were anesthetized for ambulatory surgery were analyzed retrospectively to determine the effect of the type of surgery, the age of the patient, the use of premedication, the duration of anesthesia, and the anesthetic technique on the duration of recovery and the rate of complications. In a 4-month period in 1979, 1073 patients were treated, and another 480 patients were treated during a 2-month period in 1980. Aside from patients undergoing dental surgery, the surgical procedure and the extremes of age affected neither the duration of recovery (193 +/- 97 minutes) nor the rate of complications (2.45%). ⋯ There was no relationship between anesthesia time and the duration of recovery. Patients who received local anesthesia had a significantly shorter recovery period than the whole population, and significantly fewer patients receiving local anesthesia had to be admitted to the hospital. Thus, arbitrary limits placed on the type of surgery, age of the patient, the duration of the procedure, and the use of certain premedication appear to be unwarranted.
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Concentrations of halogenated anesthetics produced by contemporary vaporizers vary from vaporizer dial settings when carrier gas is not 100% oxygen. This effect is most marked when carrier gas changes from 100% O2 to 100% nitrous oxide (N2O). ⋯ Steady-state outputs of halothane and enflurane in 100% N2O were 10% below dial settings. The significance of these changes in administration of closed-circuit anesthesia with an out-of-circuit vaporizer is discussed.