Barash Highlights

Question 1

two primary concerns for ambulatory anesthesia

Answer 1

speed of wake up

incidence of PONV

Question 2

what is the largest factor for unanticipated admissions after ambulatory surgery

Answer 2

nausea with or without vomiting

Question 3

patients remain in phase 2 recovery until they are able to do what?

Answer 3

tolerate liquids, walk and depending on the operation- walk

Question 4

medications that should be avoided on the day of surgery

Answer 4

ace/arb
diuretics
anticoagulants/antiplatelets
oral hypoglycemia agents
vitamins (e)-platelets
herbal supplements (bleeding)

Question 5

medications that should be taken on the day of surgery

Answer 5

b blockers
statins
antiarrythmias
antihypertensives -excpet ace arb diuretic
pulmonary inhalers
pain meds-except nsaids
antiseizure
hyperthyroid meds

Question 6

techniques to decrease postoperative n&v

Answer 6

use regional anesthesia alone if possible
if general is needed use propofol infusion instead of inhalation
avoid use of nitrous oxide
minimize use of preoperative opioids
avoid paralysis
consider adequate hydration

Question 7

what remains an important risk of an office based procedure

Answer 7

pulmonary embolism arising from deep vein thrombosis

Question 8

causes of injury in the office-based practice

Answer 8

inadequate resuscitation equipment
inadequate monitoring-lack of pulse ox
inadequate preoperative and postoperative evaluation
slow recognition of an event
slow response of an event
lack of experience
drug overdosage

Question 9

class a surgical procedure

Answer 9

minor surgical procedure
local topical or infiltration of local
no sedation preoperatively or intraoperateivly

Question 10

class b surgical procedure

Answer 10

minor or major surgery
sedation via oral rectal or iv sedation
analgesic or dissociative drugs

Question 11

class c surgical procedure

Answer 11

minor or major surgery
general anesthesia
major conduction block anesthesia

Question 12

children with mild to moderate tonsils enlargement- you must consider them to have what breathing problems sleeping and awake

Answer 12

upper airway obseruction while awake and apnea during sleep. do not underestimate the severity of the problem just based on tonsillar size

Question 13

patients with osa have an increased sensitivity to what medication and doses should be decreased how much

Answer 13

opioids doses should be reduced by 50%