Outpatient Surgery Magazine

The Trouble With Transvaginal Mesh - August 2016 - 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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M A Y 2 0 1 6 • O U T PA T I E N T S U R G E R Y. N E T • 3 1 Topical or Block: What's Best for Cataracts? Factors to consider before you choose one method over another. W hat's the best way to anesthetize cataract patients — topical anesthesia or nerve blocks? Regardless of your preference, intravenous sedation given beforehand helps reduce anxiety and keep patients comfortable. It also helps patients hold relatively still, as long as you don't administer too large of a dose. Administer too much and patients may fall asleep and either snore — moving their heads slightly when they do — or suddenly wake up and jerk their heads, momentarily unaware of their whereabouts. Beyond that, the topical block debate depends on several factors. Let's look at some of the considerations. Is eye movement OK? If you choose topical anesthesia, patients will be able to move their eyes, which is fine as far as many surgeons are concerned. The key is that those patients are properly sedated and comfortable. But if you use topical without sedation, you may need to supplement it with an intracameral injection of bupivacaine — an injection within the anterior chamber of the eye. Typically, that's enough to keep patients comfortable, because the procedure will likely be completed well before the anesthetic wears off. Anesthesia Alert Perry Ruspantine, CRNA, APRN • TOPICAL VS. BLOCK With topical anesthesia (left), patients should be sedated enough that they feel comfortable and relaxed, but not so sedated that they fall asleep. While blocks (right) have a higher risk for complications, some surgeons still feel they're safer overall. Pamela Bevelhymer, RN, BSN

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