Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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The fast-tracking recovery concept examines different paradigms for streamlining the postoperative recovery process. Fast-tracking anesthetic techniques allow suitable outpatients to be discharged earlier after ambulatory surgery. Outpatients are normally transferred from the OR to the PACU, followed by transfer to the Phase II step-down (day-surgery unit) before discharge home. ⋯ For these PACU fast-track patients, less monitoring is performed, a family member is permitted to be with the patient, and the patient is allowed to ambulate, change into street clothes, and be discharged home directly from the PACU without any time restrictions. Preliminary studies have shown that outpatients who are fast-tracked can be discharged home earlier without any increase in complications or side effects. Importantly, fast-tracking after ambulatory surgery does not seem to compromise patient satisfaction with the surgical experience.
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Elective surgical procedures are moving from hospital-affiliated and freestanding ambulatory centers to the physician office. Anesthetic risk has decreased dramatically during the past decade; however, perioperative safety is ill defined when the surgical procedure is performed in the physician office. ⋯ Regulation of office-based surgery is now being addressed by specialty organizations and Departments of Health or Boards of Medical Examiners. A comprehensive study of perioperative risk for patients receiving office-based surgical care is needed.
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The preanesthesia assessment is an important tool for both the perianesthesia team and the patient. A complete and thorough preoperative assessment prepares the perianesthesia team to form the best possible patient care plan. By using the preanesthesia assessment as an opportunity to provide comprehensive teaching about the entire perianesthesia process, the patient is prepared and motivated for the best possible outcome.
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J. Perianesth. Nurs. · Dec 2001
ReviewPharmacologic rationale for anesthetic agents in ambulatory practice.
Patients undergoing surgery in the ambulatory setting require anesthetic agents that expedite postoperative recovery, minimize adverse side effects, and contribute to patient satisfaction. The newer anesthetic agents that are currently used in today's practice offer the flexibility needed to provide anesthesia care for a wide variety of diagnostic and therapeutic procedures performed on an outpatient basis. ⋯ This article focuses on the rationale for the use of a variety of anesthetic and related agents necessary for the provision of ambulatory anesthesia. The commonly used agents used in ambulatory anesthesia care and their influences on the continuum of care is reviewed.
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Effective postoperative analgesia is a fundamental goal of patient management in the ambulatory surgery setting. There is a physiologic, psychological, and economic cost to unrelieved pain in the postoperative patient. ⋯ Severe postoperative pain continues to be a problem in ambulatory patients once they are discharged to the home environment. This article looks at fundamental concepts in pain management and integrates these ideas into a comprehensive strategy for the management of postoperative pain in the ambulatory patient.