Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Apr 1995
Review[Analgesia of postoperative pain in ambulatory surgery].
Although the role of outpatient surgery has become increasingly important in the campaign to reduce waiting lists and health care costs, careful control and treatment of postoperative pain too often receives slight attention. Pain control after surgery must produce high quality analgesia without lengthening the hospital stay or increasing the risk of complications. ⋯ Anesthesiologists must therefore take preventive measures as well as apply techniques during and after surgery that diminish the intensity of pain and the incidence of nausea or vomiting. Drugs that act in the short term and have few side effects, regional anesthesia (depending on type of operation), non-opioid analgesics and balanced analgesia seem to give good quality control of pain after outpatient surgery.
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The process of quality control and auditing of anesthesiology allows us to evaluate care given by a service and solve problems that are detected. Quality control is a basic element of care giving and is only secondarily an area of academic research; it is therefore a meaningless effort if the information does not serve to improve departmental procedures. Quality assurance procedures assume certain infrastructural requirements and an initial period of implementation and adjustment. The main objectives of quality control are the reduction of morbidity and mortality due to anesthesia, assurance of the availability and proper management of resources and, finally, the well-being and safety of the patient.
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Rev Esp Anestesiol Reanim · Nov 1994
Review[Prevention of cross contamination, patient to anesthesia apparatus to patient, using filters].
Concern for cross infections from patient to patient via apparatus is particularly relevant today. There are several ways to prevent patient contamination through anesthetic devices. Although there is no clinical evidence for using one alternative over another and each hospital establishes its own hygienic protocols, we have introduced the systematic use of filters with patients undergoing general anesthesia. ⋯ We describe three basic physical tests (passage of water, passage of smoke and increase of resistance when applied to the patient) for filters to be classified. The ideal filter is hydrophobic and does not increase circuit resistance over the amount specified. Four principles are emphasized in the protocol: 1) the filter forms a part of the patient, not the apparatus; 2) proper placement of the filter is between the patient and the circuit's "Y" piece; 3) the main purpose of the filter is to prevent contamination of the apparatus, and 4) if a hydrophobic filter is used with each patient, the use of a disposable respiratory circuit is not called for.