Ch. 37-Miller & Pardo Flashcards
Name top procedures done in outpatient settings
lens and cataract operations
orthopedic procedures
laparoscopic cholecystectomy
Why is appendectomy not preformed outpatient
difficult to do as patients come in emergently when the ASC is not open
considerations for thyroidectomy and parathyroidectomy outpatient
complications such as acute postoperative airway compromise- hypocalcemia, bleeding and hematoma make it a good case for inpatient
Yet they do have good postoperative morbidity and mortality profiles.
most outpatient setting are the result of___not patient selection
inadequate monitoring
OSA - name the components for evaluating this
snoring tiredness during the day observed apnea pressure: increased blood pressure body mass index>35 age> 50 neck circumference greater 40 gender -male
less than 3 points for osa
low likelihood
3-6 points for osa
adequate positive screen-further testing needed
greater or equal 5 points
high likelihood of osa
patients with chronic pain getting surgery
will likely need 100%-200% dose increase in baseline opioids post operativ- may be best managed in hospital- ensure these patients are screened appropriately
name a risk of using remifentanil in the outpatient setting
hyperalgesia.-making it unsuitable for patients having painful surgery or a history of chronic pain.
concerns with deep mac
gerd, osa,
general anesthesia carries a increased risk for
PONV
preop medications to consider for anxiety
gabapentin dex-precedex nsaids lyrica acetaminophen
scopalamine
name the three phases of recovery
early intermediate and late
early phase of recovery 1
occurs until anesthesia or surgically induced derangements in protective reflexes and motor function resolve
