Anesthesiology clinics
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Performing an anesthetic in a procedure suite instead of in the operating room can be extremely challenging for the anesthetist. Not only are the procedures performed outside of the operating room becoming increasingly more complex but also patient acuity is increasing. In some cases, the out-of-operating room procedure may be selected as a less risky alternative to an operating room procedure in an extremely high-risk patient. Effective preprocedure evaluation and preparation are critical to achieve optimal clinical outcomes and maximal operational efficiency in these areas.
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This article discusses the anesthesiologist's role in diagnostic and therapeutic radiologic procedures. It addresses the use of monitored anesthesia care, regional anesthesia, and general anesthesia, with an emphasis on patient safety. The discussion is based on guidelines published by the American Society of Anesthesiologists and the American College of Radiology.
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Traditionally, sedation for gastrointestinal endoscopic procedures was provided by the gastroenterologist. Increasingly, however, complex procedures are being performed on seriously ill patients. As a result, anesthesiologists now are providing anesthesia and sedation in the gastrointestinal endoscopy suite for many of these patients. This article reviews the challenges encountered in this environment and anesthetic techniques that can be used successfully for these procedures.
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Anesthesiology clinics · Mar 2009
The role of the out-of-operating room anesthesiologist in the care of the cardiac patient.
Modern invasive cardiovascular procedures require patients to be both comfortable and cooperative. In addition, these procedures demand the complete attention of the attending cardiovascular specialist, and, to a large degree, the outcomes of these procedures depend on the amount of focus and concentration the cardiovascular specialist can give to performing the procedure itself. ⋯ This article clearly delineates the procedures cardiologists perform that might involve anesthesiologists. Mutual knowledge, understanding, and respect are fundamental requirements for integration of cardiology and anesthesia services to optimize patient outcomes.
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Anesthesiology clinics · Mar 2009
Anesthesia in the cardiac catheterization laboratory and electrophysiology laboratory.
Procedures and interventions in the cardiac catheterization laboratory (CCL) and electrophysiology laboratory (EPL) are more complex and involve acutely ill patients. Safely caring for this growing patient population in the CCL and EPL is now a concern for all anesthesiologists and cardiologists. Anesthesiologists are uniquely trained to care for this complex patient population, allowing the cardiologist to focus on completing the interventional procedure successfully.