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COVID-19 Crisis - April 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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uncommon and usually clear up quickly. They can include lower extremity pain or headache, which could be accompanied by double vision, especially in younger patients. You'll want to ask patients if they have experienced any of these issues when making follow-up calls the day after surgery. Patient selection and assessment, including a history and physical examination of the injection site, is critical for successful use of spinal anesthesia and avoidance of complications due to contraindications. "As always, clinical care needs to be individualized," says Dr. Aziz. "That said, I think there's a lot of utility in some standardization, adhering to set pathways that are associated with reduced complica- tions. There's a benefit to setting up a primary pathway for a host of surgical procedures, and I think spinal anesthesia has a clear home in that." The better option When spinal anesthesia is administered, the needle passes through the epidural space into the subarachnoid space, where the cere- brospinal fluid resides. It takes effect much more quickly than an epidural — usually three to five minutes. Spinal is a home run for lower extremity, lower abdominal, pelvic and perineal procedures. Spinal immobilizes and desensitizes everything below the injection site, but the block wears off quickly, and bladder function and mobili- ty are rapidly restored. Side effects are few — a slight headache is the most commonly reported one. All of this is perfect for outpatient surgery. OSM Managing Editor Jared Bilski contributed reporting to this story. 6 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 2 0

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