Outpatient Surgery Magazine

A Drug Diverter Comes Clean - Subscribe to Outpatient Surgery Magazine - December 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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D E C E M B E R 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 7 • Coughing during surgery. If the patient has a coughing fit in the OR, deliver an IV push of 100 mg of lido- caine. All it takes is about 15 sec- onds, or one circulation. The lido- caine goes from the arm to central circulation, and then to pulmonary circulation, where it blunts the reflexes of the trachea, the larynx and the recurrent laryngeal nerve system. One caution: Make absolute- ly sure the effect has subsided before you let patients drink anything in post-op. Otherwise, the involuntary protective mechanisms that protect their lungs may not function properly. I've used the IV lidocaine technique mostly during eye surgeries, but it's a good one to have in your arsenal for any kind of delicate con- scious-sedation surgery around the face, including cataract surgery (see sidebar). And with increasing numbers of patients taking ACE inhibitors, which are known to cause chronic coughing, for high blood pressure, it's likely to become more and more useful as time goes on. Michael W. Barts, CRNA Barts Professional Pain Service montanan@itstriangle.com Coughing Spell Cost Patient Her Vision A 77-year-old woman who had a coughing fit during cataract surgery might not have lost the vision in one eye (osmag.net/yebzg3) had her anesthesiologist employed either or both of these strategies.

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