scholarly journals Tu1126 MONITORED ANESTHESIA CARE IS SAFE AND EFFICIENT FOR ADVANCED ENDOSCOPIC PROCEDURES IN A UNIVERSITY HOSPITAL SETTING

2020 ◽  
Vol 91 (6) ◽  
pp. AB556
Author(s):  
Jasmine Sinha ◽  
Alexandra Sals ◽  
Michael Manka ◽  
Mary Kwasny ◽  
Sri Komanduri
Keyword(s):  
Hospital Setting ◽  
University Hospital ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Endoscopic Procedures

scholarly journals Sa1143 Monitored Anesthesia Care Versus Conscious Sedation for Common Endoscopic Procedures. A Prospective Patient Satisfaction and Procedure Outcome Study

2013 ◽  
Vol 144 (5) ◽  
pp. S-213
Author(s):  
Muhammad Asif A. Virk ◽  
Ghulam Mujtaba ◽  
Kinesh Changela ◽  
Raveendra B. Chigurupati ◽  
Elena N. Zamora ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Conscious Sedation ◽  
Anesthesia Care ◽  
Outcome Study ◽  
Monitored Anesthesia Care ◽  
Endoscopic Procedures

scholarly journals Aspiration Induced by Remifentanil

2014 ◽  
Vol 121 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Johanna Savilampi ◽  
Rebecca Ahlstrand ◽  
Anders Magnuson ◽  
Håkan Geijer ◽  
Magnus Wattwil
Keyword(s):  
Grip Strength ◽  
University Hospital ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
Double Blind ◽  
Significant Difference ◽  
Swallowing Difficulties ◽  
Swallowing Difficulty ◽  
Radionuclide Tracer ◽  
The Difference

Abstract Background: Remifentanil is widely used for monitored anesthesia care in spontaneously breathing patients. However, the authors’ previous studies have shown that remifentanil induces subjective swallowing difficulties, which may increase the risk of aspiration. Methods: Twenty-five healthy volunteers participated in a double-blind, randomized, crossover trial at the University Hospital in Örebro, Örebro, Sweden. The volunteers were studied on two different occasions during which they received either remifentanil with an effect-site target concentration of 3 ng/ml or saline over 1 h. A radionuclide tracer was infused simultaneously into the nasopharynx at a rate of 0.1 ml/min. Aspiration was determined by lung scans, and subjective swallowing difficulties and grip strength were evaluated. The primary outcome was the difference in occurrence of aspiration between remifentanil and placebo treatments. The secondary outcomes were differences in swallowing difficulty and grip strength and the association between aspiration and swallowing difficulty. Results: During remifentanil and placebo infusion, 48 and 12% of the volunteers aspirated, respectively, difference: 36% (95% CI, 10 to 62%). A similar significant difference was found for swallowing difficulties but not for the association between aspiration and swallowing. No difference was found in grip strength between the two treatments. Conclusions: Remifentanil infusion at concentrations used in monitored anesthesia care increases the incidence of aspiration. However, the subjective swallowing difficulty induced by remifentanil is not indicative of the aspiration risk.

Anästhesie bei ophthalmologischen Operationen – eine Standortbestimmung

2016 ◽  
Vol 73 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Jens Moll ◽  
Mark Kaufmann
Keyword(s):  
Anesthesia Care ◽  
Monitored Anesthesia Care

Zusammenfassung. Ein Grossteil der opthalmologischen Eingriffe kann heute in Lokoregionalanästhesie mit «Monitored Anesthesia Care» (MAC) durchgeführt werden. Allgemeinanästhesieverfahren sind hauptsächlich im pädiatrischen Segment, bei spezifischer Comorbidität und bei langdauernden Eingriffen mit völlig ruhiggestelltem OP-Gebiet notwendig. Kataraktoperationen bei mehrheitlich geriatrischen Patienten gehören aufgrund Ihrer Häufigkeit zur sogenannten «Hochvolumen-Chirurgie»: In Anbetracht des niedrigen perioperativen Risikos bei dieser Patientengruppe sind angepasste, optimierte Prozesse sinnvoll. Eine fokussierte Prämedikation und Information dieser Patienten gewährleistet eine gute perioperative Compliance. Präoperative Untersuchungen sollen bei dieser Patientengruppe nur in Abhängigkeit von relevanter Comorbidität durchgeführt werden. Neben der klassischen Anästhesiesprechstunde stehen heute für gesundheitlich kompensierte Patienten auch neue Verfahren wie eine internetbasierte Prämedikationsvisite zur Verfügung. Das intraoperative Anästhesieverfahren hängt von den Erfordernissen des Chirurgen und den Erwartungen und Kooperationsmöglichkeiten des Patienten ab.

scholarly journals Negative-pressure-related diffuse alveolar hemorrhage after monitored anesthesia care for vertebroplasty: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Negative Pressure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Unknown Etiology ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
X Ray ◽  
Chest X Ray

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.

SNORING IS ASSOCIATED WITH UNEXPECTED PATIENT HEAD MOVEMENT DURING MONITORED ANESTHESIA CARE VITREORETINAL SURGERY

Retina ◽  
2012 ◽  
Vol 32 (7) ◽  
pp. 1324-1327 ◽  
Author(s):  
Colin A. Mccannel ◽  
Eric J. Olson ◽  
Mark J. Donaldson ◽  
Sophie J. Bakri ◽  
Jose S. Pulido ◽  
...  
Keyword(s):  
Head Movement ◽  
Vitreoretinal Surgery ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

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