Current opinion in anaesthesiology
-
Curr Opin Anaesthesiol · Dec 2008
ReviewOffice-based anesthesia: new frontiers, better outcomes, and emphasis on safety.
Office-based anesthesia has grown and continues to grow very rapidly in the ever-changing medical environment. The demand of patients, surgeons and the evolving economic environment has set off a dynamic growth explosion. This explosion has created aggressive and tumultuous enhancements, some of which have been adapted well and some of which have led to disastrous results. ⋯ The review of recent literature and technological advances has provided some valuable lessons in the evolution of patient safety and office based technology for the surgical office-based environment. As this specialty grows, measures of its outcome parameters will allow a gauge of performance.
-
Advances in minimally invasive procedures have resulted in an increased demand for procedural sedation. Patient-controlled sedation (PCS) has been in clinical use for almost 20 years, but has not been reviewed in over 10 years. ⋯ PCS has been applied to a wide variety of procedures, but systems that can be applied 'off-the-shelf' are not easy to tune. New approaches to PCS may address these limitations. Better understanding of the psychology of sedation may lead to better patient acceptance of PCS.