ASSESSING PATIENTS RECEIVING INTRAUTERINE DEVICE INSERTIONS IN THE MAIN OPERATING ROOM FOR FITNESS TO THE AMBULATORY GYNAECOLOGIC SURGERY CLINIC: A RETROSPECTIVE CHART REVIEW

2019 ◽  
Vol 41 (5) ◽  
pp. 715
Author(s):  
Elise Dalton
2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Somchai Amornyotin ◽  
Prapun Aanpreung

Objectives. To review our sedation practice and to evaluate the clinical effectiveness of an anesthesiologist-administered intravenous sedation outside of the main operating room for pediatric upper gastrointestinal endoscopy (UGIE) in Thailand.Subjects and Methods. We undertook a retrospective review of the sedation service records of pediatric patients who underwent UGIE. All endoscopies were performed by a pediatric gastroenterologist. All sedation was administered by staff anesthesiologist or anesthetic personnel.Results. A total of 168 patients (94 boys and 74 girls), with age from 4 months to 12 years, underwent 176 UGIE procedures. Of these, 142 UGIE procedures were performed with intravenous sedation (IVS). The mean sedation time was minutes. Propofol was the most common sedative drugs used. Mean dose of propofol, midazolam and fentanyl was  mg/kg/hr,  mg/kg/hr, and  mcg/kg/hr, respectively. Complications relatively occurred frequently. All sedations were successful. However, two patients became more deeply than intended and required unplanned endotracheal intubation.Conclusion. The study shows the clinical effectiveness of an anesthesiologist-administered IVS outside of the main operating room for pediatric UGIE in Thailand. All complications are relatively high. We recommend the use of more sensitive equipments such as end tidal and carefully select more appropriate patients.


Author(s):  
Alex Macario ◽  
Deepak Sharma

What does a manager need to think about when scheduling cases requiring anesthesia outside the operating room (OOOR)? This chapter aims to answer that question by discussing some key strategic points that can facilitate a more efficient workday. The concepts of block scheduling and utilization apply in the OOOR setting as they do in the operating room, but there are added challenges given the increased physical distance to the main operating room suite. These challenges will be identified and recommendations will be provided on how to evaluate and improve OOOR efficiency. With more procedures being done OOOR, it is important for anesthesia groups to be mindful of these challenges and position themselves appropriately.


2019 ◽  
Vol 13 (2) ◽  
pp. 144-151 ◽  
Author(s):  
Michelle T. Sugi ◽  
Brandon Ortega ◽  
Lane Shepherd ◽  
Charalampos Zalavras

Background. There is no consensus in the literature regarding the necessity of syndesmotic screw removal, but the majority of surgeons prefer screw removal in the operating room. Purpose. The aim of this study is to analyze the safety and cost-effectiveness of syndesmotic screw removal in the clinic. Methods. A retrospective chart review was performed on all acute, traumatic ankle fractures that required syndesmotic stabilization over 5 years at a level 1 trauma center. Radiographs were evaluated for maintenance of syndesmotic reduction. Orthopaedic clinic visits and operating room costs were calculated. Results. Of 269 patients, syndesmotic screws were successfully removed in the clinic in 170 patients and retained in 99 patients. Two superficial infections (1.2%) developed following screw removal. The superficial infection rate was 3.3% (2 of 60) in patients who did not receive antibiotics compared with 0% (0 of 110) in patients who received antibiotics (P = .12). No patient lost syndesmotic reduction after screw removal. Cost savings of $13 829 per patient were achieved by syndesmotic screw removal in the clinic. Conclusion. Our study demonstrates that syndesmotic screw removal in the clinic is safe, does not result in tibiofibular diastasis, is cost-effective, and results in substantial financial savings. Level of Evidence: Level IV


2019 ◽  
Vol 7 (7) ◽  
pp. e2298 ◽  
Author(s):  
Anna K. Steve ◽  
Christaan H. Schrag ◽  
Alice Kuo ◽  
A. Robertston Harrop

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