• Curr Opin Anaesthesiol · Dec 2017

    Review

    Complications and unplanned admissions in nonoperating room procedures.

    • Kate Leslie and Benjamin Kave.
    • aDepartment of Anaesthesia and Pain Management, Royal Melbourne Hospital bAnaesthesia, Perioperative and Pain Medicine Unit, Melbourne Medical School, University of Melbourne cDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
    • Curr Opin Anaesthesiol. 2017 Dec 1; 30 (6): 658-662.

    Purpose Of ReviewThe purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites.Recent FindingsThe range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions. Deep propofol-based sedation is associated with more complications than lighter sedation. Older patients suffer more complications but obstructive sleep apnea does not appear to increase risk. Sedation improves patient comfort during bronchoscopy. Propofol-based sedation is associated with fewer complications than benzodiazepine-based sedation, but all combinations are associated with high patient satisfaction. Obesity and obstructive sleep apnea are not associated with worse outcomes in bronchoscopy patients. Sedation is increasingly required for interventions in the radiology suite. When patients are involved in choosing sedation depth, there is a trend to lighter sedation and high patient satisfaction.SummarySedation and anesthesia are required for the increasing number of increasingly complex procedures being undertaken outside the operating suite. Large randomized trials are required to define the optimum sedation drugs, sedation depth and sedation provider.

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