Office-Based Anesthesia for the Urologist - 31/10/13

Doi : 10.1016/j.ucl.2013.07.008

Ursula Galway, MD ^a,^⁎ , Raymond Borkowski, MD ^b
^a Department of Anesthesiology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve, Cleveland Clinic, E/31, 9500 Euclid Avenue, Cleveland, OH 44195, USA
^b Department of Anesthesiology, Cleveland Clinic, E/31, 9500 Euclid Avenue, Cleveland, OH 44195, USA

^∗Corresponding author.

Résumé

This article describes office-based surgery and office-based anesthesia (OBA), including the safe setup of OBA and safety concerns regarding OBA. Also discussed are the preoperative selection and workup of a patient undergoing OBA, anesthetic options, the prevention and treatment of postoperative nausea, vomiting, and pain, and planning for safe discharge.

Le texte complet de cet article est disponible en PDF.

Keywords : Office-based anesthesia, Office-based surgery, Patient safety, Non–operating-room anesthesia, Preoperative evaluation, Postoperative nausea and vomiting, Postoperative analgesia, Recovery from anesthesia

Plan

Key points

Introduction

Facility considerations and accreditation

Monitoring and equipment

Procedure suitability

Patient safety in office-based surgery

Patient selection for ambulatory surgery

Preoperative evaluation

Cardiovascular Disease

Gastrointestinal

Prior Anesthetic History

Allergies and Social Habits

Medications

Preoperative laboratory testing

Pregnancy Testing

Complete Blood Count

Renal Function and Electrolytes

Blood Glucose

Prothrobin Time/Activated Partial Thromboplastin Time/International Normalized Ratio

Monitored Anesthesia Care

General Anesthesia

General Anesthesia with Laryngeal Mask Airway Versus General Anesthesia with Endotracheal Tube

Regional Anesthesia

Postoperative nausea and vomiting

Antiemetic options for prophylaxis of PONV

Rescue therapy

Options for postoperative pain management

Discharge criteria and fast-tracking

Summary

Disclosure: Please note that the design and conduct of the work was performed by all the authors. The article has been written, read, and approved by all of the authors; and the material has not been published, whole or in part, nor is it being sent for consideration for publication elsewhere. Neither Dr Ursula Galway nor Dr Raymond Borkowski have any relationship with a commercial company that has a direct financial interest in the subject matter or materials discussed in this article, or with a company making a competing product.