Clinics in plastic surgery
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Although regional anesthesia techniques seem to expand the opportunity for cost savings when executing plastic surgery procedures, cost allocation is not a simple business. Equivalence must first be demonstrated, and the patient’s perception is integral to assigning value to an intervention. ⋯ Most importantly, the system must be modified to optimize the cost savings realized through the intervention. This article presents an in-depth look into the multiple factors that must be taken into consideration when assessing costs related to anesthesia.
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Peripheral nerve block is well suited for distal extremity surgery. Blocking the nerves at the distal extremity is easily done. It does not require ultrasound or stimulators to identify the nerve. ⋯ The distal nerves in the lower extremity are sensory branches of the sciatic nerve. This provides a sensory block only. This has the advantage of allowing the patient to actively contract tendons in the foot and ambulate more quickly after surgery.
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The evolution of liposuction has been multidisciplinary. The tumescent variant was developed using dilute local lidocaine and epinephrine and was meant to specifically exclude additional intravenous sedation, regional or general anesthesia, and intravenous fluids. Clinical pharmacology, pathophysiology, and safety studies are reviewed in this article. Tumescent formulations for varied anatomic sites are discussed, as well as other indications for tumescent anesthesia.
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Ambulatory surgery is commonplace for a multitude of procedures and a wide range of patients. The types of procedures performed in the ambulatory setting are becoming more work-intensive, and patients with comorbidities make for a challenging environment. For a safe environment for surgery in ambulatory facilities, the complex task of patient selection is necessary. Until an algorithm is created that includes provider, procedure, facility, and patient comorbidites, clinicians must rely on general guidelines rather than precise recommendations.