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Would You Operate On This Patient? - October 2015 - 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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3 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 | O C T O B E R 2 0 1 5 Putting 3 Anesthesia Dogmas to Sleep It's time to banish these old ideas about anesthesia. M any commonly held dogmas of anesthesia are passed down from mentor to student and eventually become institutional "knowl- edge" because people have never questioned them. We know, however, that it's always incumbent upon practitioners to ask the most important ques- tion we can ever ask, which is why, and to review the research our- selves. Here are a few examples of anesthesia dogmas that should be banished. Dogma No. 1: Women who are breastfeeding should "pump and dump" for 24 hours after being given a general anesthetic. The reality: The total dose of anesthetic drugs ingested by breastfeeding infants is negligible, as is the intestinal absorption of these drugs by suckling infants. That's why many experts say the best advice for nursing mothers is to continue breastfeeding as soon as they're awake enough to safely do so (see osmag.net/xMFu6J and osmag.net/J6tzJN). The only exceptions are premature infants and those suffering from apnea, as respiratory depression problems could arise. In those cases, it's a good idea to consider waiting 24 hours. Dogma No. 2: You do not have to reverse muscle relaxant if you detect 4 strong twitches in a train-of-four (TOF) assessment. A N E S T H E S I A A L E R T Mike MacKinnon, CRNA z WRIST ASSESSMENT Four strong twitches aren't enough to preclude the need for reversal agents. Mike MacKinnon, CRNA

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