Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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The preanesthesia assessment is an important tool for both the perianesthesia team and the patient. A complete and thorough preoperative assessment prepares the perianesthesia team to form the best possible patient care plan. By using the preanesthesia assessment as an opportunity to provide comprehensive teaching about the entire perianesthesia process, the patient is prepared and motivated for the best possible outcome.
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J. Perianesth. Nurs. · Dec 2001
ReviewPharmacologic rationale for anesthetic agents in ambulatory practice.
Patients undergoing surgery in the ambulatory setting require anesthetic agents that expedite postoperative recovery, minimize adverse side effects, and contribute to patient satisfaction. The newer anesthetic agents that are currently used in today's practice offer the flexibility needed to provide anesthesia care for a wide variety of diagnostic and therapeutic procedures performed on an outpatient basis. ⋯ This article focuses on the rationale for the use of a variety of anesthetic and related agents necessary for the provision of ambulatory anesthesia. The commonly used agents used in ambulatory anesthesia care and their influences on the continuum of care is reviewed.
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Effective postoperative analgesia is a fundamental goal of patient management in the ambulatory surgery setting. There is a physiologic, psychological, and economic cost to unrelieved pain in the postoperative patient. ⋯ Severe postoperative pain continues to be a problem in ambulatory patients once they are discharged to the home environment. This article looks at fundamental concepts in pain management and integrates these ideas into a comprehensive strategy for the management of postoperative pain in the ambulatory patient.
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The most common fear expressed by preanesthesia patients is experiencing awareness while under general anesthesia. Although extremely rare, awareness during anesthesia does occur and patients have recalled explicit details and conversations that occurred while they were under general anesthesia, including described recall of the intubation process. The Bispectral Index Monitor (BIS) was developed by Aspect Medical System of Newton, MA, to measure patient response to the administration of potent sedative, hypnotic agents. The BIS monitor is intended to decrease the risk of intraoperative awareness by providing the anesthetist with a quantitative assessment regarding the hypnotic state of the patient.
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Elective surgical procedures are moving from hospital-affiliated and freestanding ambulatory centers to the physician office. Anesthetic risk has decreased dramatically during the past decade; however, perioperative safety is ill defined when the surgical procedure is performed in the physician office. ⋯ Regulation of office-based surgery is now being addressed by specialty organizations and Departments of Health or Boards of Medical Examiners. A comprehensive study of perioperative risk for patients receiving office-based surgical care is needed.