Procedural sedation analgesia considerations for ASC leaders
The promise of quicker recovery and fewer complications from sedation, anesthesia, and pain management have drawn clinicians and patients alike to procedures performed in ambulatory surgery centers (ASCs) and other outpatient settings. However, sedation, anesthesia, and analgesia add their own risks to those of the procedure itself. Understanding the latest…
Obstructive sleep apnea associated with risk of postoperative delirium
Editor's Note Patients with a history of obstructive sleep apnea (OSA) have a higher risk of delirium after high-complexity surgeries but not after those of moderate complexity, according to findings published in the March issue of Anesthesia and Analgesia. The study included 46,352 hospital patients older than 60 years who…
Study: Microglia help awaken the brain from anesthesia, protect neurons from aftereffects
Editor's Note A new study finds that the same cells that are involved in preventing damage to the central nervous system – called microglia – help to awaken the brain following anesthesia. The findings appeared January 4 in the journal Nature. Using electron-microscopy-based synaptic reconstruction, the researchers could see the…
Administering sedative preoperatively deemed safe for older patients
Editor's Note Researchers conducted the largest randomized study to date on use of the sedative midazolam in older patients, a drug sometimes used to calm patients prior to surgery. The results were published in JAMA Surgery on December 20. Highlights include: The study involved nine German hospitals and included more…
Patients more likely to be discharged home with anesthesiologist-administered sedation
Editor's Note Anesthesiologist-administered or -directed sedation leads to higher rates of patient discharges to home rather than a long-term care (LTC) facility, according to a study presented at the Anesthesiology 2023 annual meeting. The study focused on interventional radiology (IR) procedures–specifically 9,682 patients who had sedation in the IR suite…
Study: Introducing propofol to ambulatory anesthesia may improve endoscopy quality metrics
Editor's Note A study presented at the 2023 annual meeting of the Society for Ambulatory Anesthesia suggests that implementing ambulatory anesthesia services with propofol can significantly enhance various quality metrics in outpatient endoscopy procedures, Anesthesiology News August 28 reports. The study, led by Justin Routman, MD, director of non-OR anesthesia…
COVID-19 driving the move to regional anesthesia
Cancellations of some surgical procedures during the COVID-19 pandemic and case rescheduling have been a major focus for perioperative leaders. But changes are also occurring in anesthesia practices. For many surgical procedures, the use of regional anesthesia or nerve blocks, coupled with light sedation, is reported to double if the…
FDA: Class I recall of Alaris Infusion Pump Module 8100
Editor's Note The Food and Drug Administration, on April 30, identified the recall of the Alaris Infusion Pump Module 8100 as Class I, the most serious. The Pacific Medical Group (DBA Avante Health Solutions) is recalling the infusion pump because the front bezel components may crack or separate, leading to…
Joint Commission approves four new EPs for office-based surgery
Editor's Note The Joint Commission, on January 13, announced that it had approved four new elements of performance (EPs) for office-based surgery practices that prescribe medication. The EPs for Medication Management Standard MM.04.01.01, which will become effective July 1, address the following: Having a written policy that identifies specific medication…
Preoperative protocols enhance outpatient total joint outcomes
On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began reimbursing healthcare providers for total hip arthroplasty performed in outpatient hospital settings and total knee arthroplasty in ambulatory surgery centers (ASCs), thereby opening the floodgates for explosive growth in outpatient total joint arthroplasty (TJA). About a million…
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