Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Anesthesia - July 2017

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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4 6 S U P P L E M E N T T O 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 J U LY 2 0 1 7 utes post-operatively. I want to avoid a larger bolus of narcotics, which might not be necessary and most likely will trigger nausea and vomiting. I rarely supplement pain relief with more than a few doses of Demerol. There are always exceptions, of course, such as chronic pain patients whose narcotic needs aren't being met. If patients say they're still in pain after receiving Demerol 50 mg and their blood pressure and heart rate are within normal limits, I'll occasionally use a low dose of Versed or Valium. This will reduce anxiety, and satisfy a patient's request for additional pain relief. 4. Keep patients warm. Patients dislike waking up cold. In addition, shiv- ering can increase cardiac oxygen demands significantly. I prefer to warm patients near the end of a procedure, rather than actively warming them throughout the case. For longer procedures, I'll actively warm the patient during induction (for comfort) and during the last hour of the case. Surgeons frequently have concerns about infection from blowing air or from the temperature of the room when warm- ers are used continuously. When patients wake up shivering, I treat them with Demerol. There is also evidence that preventing hypothermia can reduce risk of SSIs. Team player I see myself as an important part of the OR team. Not so much as the manager directing all facets of patient satisfaction, but more as the third base coach pro- viding some important direction. I'm not boasting when I say the best and the busiest plastic, reconstructive and orthopedic surgeons in Orange County, Calif., frequently request me to work their cases. There's one simple reason: Patient feedback is overwhelmingly positive post-operatively. Recovery room nurses and surgeons agree there are differences in patient emergence and recovery room behaviors based on the quality of the anesthetic delivered. OSM

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