Anesthesia Outside The OR

Question 1

What is the concentration of the infiltrating solution used in tumescent anesthesia?

What is the recommended max dose of this solution?

Answer 1

The tumescent technique is done for smaller amounts of tissue (< 3,000 ml) and is usually done under monitored anesthesia care. (advised that the total aspirate be limited to 5,000 ml.

The infiltrating solutions are diluted to an epinephrine concentration of 1:100,000

Max dose is 55mg/kg as per the American Academy of Dermatology

Question 2

What are contraindications to outpatient surgery?

Answer 2

1) If the patient does not have another responsible adult at home to care for the patient on the evening of surgery.
2) morbidly obese patients with symptomatic cardiovascular (angina) or respiratory (asthma) problems

Question 3

What things must a patient undergoing outpatient surgery under regional anesthesia be able to do prior to discharge home?

Answer 3

1) Normal perianal (S4-5) sensation
2) Must have the ability to plantar-flex the foot and have proprioception of their big toe
3) Advisable to be able to void before discharge (sympathetic nervous system)

Question 4

What is the exclusion criteria for infants presenting for outpatient surgery?

Answer 4

Postconceptual age < 56 weeks and 32 weeks post-gestation when born

< 54 weeks post conceptual age and < 35 weeks post-gestation when born

Question 5

What procedures are associated with an increased incidence of postoperative nausea and vomiting (PONV)?

Answer 5

Lumpectomy
Resection of the septal nasal submucosa
Tonsillectomy & adenoidectomy
Rotator cuff repair
Laparoscopic cholecystectomy
Knee arthroscopy

Question 6

What is the recommended limit of aspirate for liposuction procedures?

Answer 6

5,000 mL of total aspirate