Anesthesiology clinics
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Anesthesiology clinics · Jun 2014
ReviewAnesthesia information management systems in the ambulatory setting: benefits and challenges.
Adopting an anesthesia information management system (AIMS) is a challenge for anesthesia departments. The transition requires a physician champion and the support of members in every section. ⋯ Once implemented, the benefits outweigh the challenges, but understanding where the potential obstacles lie is critical to removing them efficiently and effectively. As different AIMS continue to spread throughout the medical world, so will their benefits.
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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.
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Anesthesiology clinics · Jun 2014
ReviewPerioperative consideration of obstructive sleep apnea in ambulatory surgery.
The prevalence of obstructive sleep apnea (OSA) is increasing and a significant number of patients with OSA are undiagnosed. The suitability of ambulatory surgery in patients with OSA remains controversial, and the evidence regarding the safety of ambulatory surgery for patients with OSA is limited. Preoperative screening and careful selection of patients for ambulatory surgery is the most important step. Patients diagnosed and suspected of having OSA should be managed with a systematic algorithm to improve outcomes.
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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.