Anesthesiology clinics
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Anesthesiology clinics · Jun 2014
ReviewPerioperative evaluation and management of cardiac disease in the ambulatory surgery setting.
Preoperative cardiac evaluation focuses on risk assessment and reduction. Diagnostic testing and interventions are used only when the risk of adverse outcomes is high and intervention will lower the risk. The evaluation is performed in a stepwise fashion according to guidelines in the literature.
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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
ReviewNonoperating room anesthesia for the gastrointestinal endoscopy suite.
Anesthesia services are increasingly being requested for gastrointestinal (GI) endoscopy procedures. The preparation of the patients is different from the traditional operating room practice. ⋯ The postprocedure care is also unique. The future needs for anesthesia services in GI endoscopy suite are likely to expand with further developments of the technology.
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Neuraxial anesthesia for outpatient surgery can provide excellent anesthesia for certain patients. The short-acting local anesthetic 2-chloroprocaine has an appropriate length of action for short outpatient procedures with a very low risk of transient neurologic symptoms. Epidural anesthesia with short-acting agents can provide good outpatient anesthesia for procedures lasting 90 minutes or longer.