Anesthesiology clinics
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This article updates acute pain management in ambulatory surgery and proposes a practical three-step approach for reducing the impact and incidence of uncontrolled surgical pain. By identifying at-risk patients, implementing multimodal analgesia, and intervening promptly with rescue therapies, the anesthesiologist may improve outcomes, reduce cost, and optimize the patient's experience and quality of recovery.
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Novel anesthetic and analgesic agents are currently under development or investigation to improve anesthetic delivery and patient care. The pharmacokinetic and analgesic profiles of these agents are especially tailored to meet the challenges of rapid recovery and opioid minimization associated with ambulatory anesthesia practice.
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Anesthesiology clinics · Jun 2014
ReviewLong-acting serotonin antagonist (Palonosetron) and the NK-1 receptor antagonists: does extended duration of action improve efficacy?
In a growing outpatient surgical population, postdischarge nausea and vomiting (PDNV) is unfortunately a common and costly anesthetic complication. Identification of risk factors for both postoperative nausea and vomiting and PDNV is the hallmark of prevention and management. New pharmacologic interventions with extended duration of action, including palonosetron and aprepritant, may prove to be more efficacious.
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Anesthesiology clinics · Jun 2014
ReviewInitial results from the National Anesthesia Clinical Outcomes Registry and overview of office-based anesthesia.
Safe office-based anesthesia practices dictate proper patient and procedure selection, appropriate provider qualifications, adequately equipped facilities, and effective administrative infrastructure. Analysis of patient outcomes can help reduce mortality and morbidity by identifying high-risk patients and procedures. ⋯ Increased regulation and standardization of care, such as the use of checklists and professional guidelines, can advance safe practices. There is increasing emphasis on continuous quality improvement, electronic health records, and outcomes data reporting.
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In this article, recent literature related to airway management in the ambulatory surgery setting is reviewed. Practical pointers to improve clinical success and avoid complications of newer airway management techniques are provided.