Outpatient Surgery Magazine - Subscribers

Why Do ASCs Fail? - August 2015 - 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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2 6 O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | A U G U S T 2 0 1 5 Reduce PONV by "Bookending" Propofol The key is to get gas out of the patient's system. I 've developed an anesthetic technique that significantly reduces PONV and costs, and improves patient, surgeon and nurse satis- faction. I call it "bookending," because it involves using propofol both at the beginning and at the end of a given procedure. Most general anesthetics use gas for maintenance, but it's been proven that propofol infusions without gas significantly reduce the incidence of PONV. My technique uses gas, but transitions back to propofol at the end of the procedure, after the gas is discontinued. The idea comes from a 1996 study (osmag.net/JuY6Vd) that ostensibly found that the technique doesn't work. I believe it does work, and I think I know what was wrong with that initial study. A N E S T H E S I A A L E R T Michael Reines, MD Jason Meehan z ENCORE Take advantage of propofol's antiemetic prop- erties by reintroducing it toward the end of the procedure.

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