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Let’s look at a case study which highlights a specific risk of generalanesthesia at a freestanding surgery center or a surgeon’s office operatingroom, when the anesthesiologist departs soon after the case is finished. The patient enters the operatingroom at 0730 hours. The patient consents.
Empty OperatingRoom 0655 hours—You don a bouffant hat and a facemask, and enter your operatingroom. Your hospital contains multiple operatingrooms, and today you are in room #10. Then we’ll roll down the hallway into the operatingroom. You may have nausea after generalanesthesia.
Imagine this scenario: You’ve just finished anesthetizing a patient in a hospital setting, and the patient now requires transport from the operatingroom (OR) to the post-anesthesiacare unit (PACU). All were transported to the PACU on room air without oxygen supplementation.
You’re a Medical Director or medical educator, and you’re scheduled to deliver a lecture on the management of two or three common operatingroom emergencies. You’re an expert witness or a member of your hospital’s Quality Improvement committee, charged with reviewing the unfortunate outcome of an operatingroom medical complication.
No one wants a partner who repeatedly creates conflict in the workplace, who initiates conflict with a surgeon in the operatingroom, a nurse in the postanesthesiacare unit, or an administrator. Do you think patients want a friendly anesthesiologist who is all thumbs in the operatingroom?
Louis Imagine this: You’re an anesthesiologist in the operatingroom at a busy hospital. Your patient is in mid-surgery, and you receive a call from the Anesthesia Control Tower that the patient’s blood pressure is too low, your blood transfusion replacement is inadequate, and that the patient is in danger.
The two hospital guards and the mother donned white operatingroom coveralls. At the mother’s consent, the guards laid the patient down on the hospital gurney, held him there, and the surgical team and the guards pushed the gurney down the hallway to the operatingroom (a significant distance of approximately 100 yards).
Dr. Patel has been a pioneer in bringing HFNO/THRIVE from the ICU into the operatingroom. We extended the apnea times of 25 patients with difficult airways who were undergoing generalanesthesia for hypopharyngeal or laryngotracheal surgery. Why Did Take Me So Long To Wake From GeneralAnesthesia?
The inside of the healthcare facility will be cleaned prior to any patient care, and will be recleaned after each patient leaves an operatingroom. If the procedure was an outpatient surgery, you will leave the facility and return home after you’ve recovered from anesthesia. Will I Have a Breathing Tube During Anesthesia?
Propofol infusions are typically used to make our patients sleep, and most propofol infusions cross the American Society of Anesthesiologists line into generalanesthesia. You may make the surgeon happy, and you may continue to have a safe airway under generalanesthesia in the absence of the endotracheal tube, but what if you don’t?
Their patients are obtunded on arrival to the PostAnesthesiaCare Unit (PACU) after surgery, and they rely on the PACU nursing staff to complete the job of anesthesia wake up. Some surgeons are bullies, and are condescending in their remarks and attitudes toward the anesthesia provider they’re working with.
Case study #2020: The attending surgeon and the operatingroom nurse each filed digital Adverse Event documents because of their patient’s extremely high blood pressure and heart rate, and her unplanned admission to the ICU. Case #2020: The surgeon, operatingroom nurse, and the anesthesiologist are interviewed.
When a patient decompensates emergently at a freestanding ambulatory surgery center or in an operatingroom at a doctor’s office, the facility will call for an ambulance staffed with EMT personnel. Why Did Take Me So Long To Wake From GeneralAnesthesia? Will I Have a Breathing Tube During Anesthesia?
A then records all pertinent preoperative information into the electronic medical record (EMR) via a computer keyboard and screen located just to the right of his anesthesia machine. IN THE OPERATINGROOM: Mr. Doe will be asleep for the surgery, and Dr. A will be present the entire time. The MAP decreases to 80 once again.
The surgeon is not “the captain of the ship” in the operatingroom. When you want to accelerate the heart rate in the operatingroom or the postanesthesiacare unit, use the first drug recommended in the ACLS and American Heart Association bradycardia algorithms—and that drug is atropine.
You utilize the current multimodal strategies for operatingroomanesthesia and postoperative pain reduction, including an ultrasound-guided adductor canal block with 0.5% 300 mg of morphine, and a light general anesthetic using 1-1.5% 300 mg of morphine, and a light general anesthetic using 1-1.5%
The surgery and anesthesia proceed uneventfully. The patient is awakened from generalanesthesia and taken to the PostAnesthesiaCare Unit. Abdominal surgery and generalanesthesia in this patient population are not without risk, even with optimal anesthetic care.
A recent study, “Hormonal basis of sex differences in anesthetic sensitivity,” published in 2024 in the journal Neuroscience , presented data that females recover from generalanesthesia faster than males. Wasilczuk from the Department of Anesthesiology and Critical Care at the University of Pennsylvania led the study.
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