Ambulatory Surgical Procedures

Publication Title: 
Annals of Plastic Surgery

An approach to outpatient anesthesia using drugs that have reversible or very short-acting effects is described, along with a method of monitoring patients using pulse rate to assess tranquility. Preoperatively, the patient is given 1 mg of lorazepam the evening before surgery and sublingual lorazepam 1 mg combined with hydroxyzine 50 mg intramuscularly one hour before surgery. Before infiltration of local anesthesia, intravenous diazepam in 2.5 mg increments is given if needed, followed by a mixture of meperidine and pentazocine intravenously in exactly a 10:1 ratio.

Silver, H.
Codesmith, A. O.
Publication Title: 
Same-Day Surgery
Publication Title: 

Midazolam is an imidazobenzodiazepine with unique properties when compared with other benzodiazepines. It is water soluble in its acid formulation but is highly lipid soluble in vivo. Midazolam also has a relatively rapid onset of action and high metabolic clearance when compared with other benzodiazepines. The drug produces reliable hypnosis, amnesia, and antianxiety effects when administered orally, intramuscularly, or intravenously.

Reves, J. G.
Fragen, R. J.
Vinik, H. R.
Greenblatt, D. J.
Publication Title: 

Fifty-two female patients who underwent gynaecological operations as day cases received either a short pre-operative hypnotic induction or a brief discussion of equal duration. Hypnotized patients who underwent vaginal termination of pregnancy required significantly less methohexitone for induction of anaesthesia. They were also significantly more relaxed as judged by their visual analogue scores for anxiety. Less than half of the patients were satisfied with their knowledge about the operative procedure even after discussions with the surgeon and anaesthetist.

Goldmann, L.
Ogg, T. W.
Levey, A. B.
Publication Title: 
Orvosi Hetilap

The spreading of the cost-benefit attitude is a considerable help in the progress of the one day surgery. The patient selection, the preoperative patient preparations and the preoperative examination has done in the anaestesiologic ambulance. Aims of ambulatory anaesthesia are to achieve sedation, hypnosis, analgesia, amnesia and muscle relaxation during the operation, to preserve preoperative mental and physiologic state, analgesia and to make early postoperative nourishing possible.

Darvas, K.
Janecskó, M.
Vimláti, L.
Borsodi, M.
Publication Title: 

Over 60% of surgery is now performed in an ambulatory setting. Despite improved analgesics and sophisticated drug delivery systems, surveys indicate that over 80% of patients experience moderate to severe pain postoperatively. Inadequate postoperative pain relief can prolong recovery, precipitate or increase the duration of hospital stay, increase healthcare costs, and reduce patient satisfaction. Effective postoperative pain management involves a multimodal approach and the use of various drugs with different mechanisms of action.

Shang, Allan B.
Gan, Tong J.
Publication Title: 
British Journal of Anaesthesia

BACKGROUND: General anaesthesia is a balance between hypnosis and analgesia. We investigated whether an increase in remifentanil blood concentration would reduce the amount of propofol required to maintain a comparable level of anaesthesia in 60 patients undergoing ambulatory surgery. METHODS: Patients were allocated randomly to receive remifentanil to a target blood concentration of 2 ng ml(-1) (low), 4 ng ml(-1) (medium), or 8 ng ml(-1) (high), administered by target-controlled infusion (TCI).

Milne, S. E.
Kenny, G. N. C.
Schraag, S.
Publication Title: 
The American Journal of Clinical Hypnosis

Although medical hypnosis has a long history of myriad functional applications (pain reduction, procedural preparation etc.), it has been little tested for site-specific effects on physical healing per se. In this randomized controlled trial, we compared the relative efficacy of an adjunctive hypnotic intervention, supportive attention, and usual care only on early post-surgical wound healing.

Ginandes, Carol
Brooks, Patricia
Sando, William
Jones, Christopher
Aker, John
Publication Title: 
Anesthesia and Analgesia

In this study we examined the effect of hypnosis on preoperative anxiety. Subjects were randomized into 3 groups, a hypnosis group (n = 26) who received suggestions of well-being; an attention-control group (n = 26) who received attentive listening and support without any specific hypnotic suggestions and a "standard of care" control group (n = 24). Anxiety was measured pre- and postintervention as well as on entrance to the operating rooms.

Saadat, Haleh
Drummond-Lewis, Jacqueline
Maranets, Inna
Kaplan, Deborah
Saadat, Anusha
Wang, Shu-Ming
Kain, Zeev N.
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Following the initial resuscitation of burn patients, the pain experienced may be divided into a 'background' pain and a 'breakthrough' pain associated with painful procedures. While background pain may be treated with intravenous opioids via continuous infusion or patient-controlled analgesia (PCA) and/or less potent oral opioids, breakthrough pain may be treated with a variety of interventions. The aim is to reduce patient anxiety, improve analgesia and ensure immobilization when required.

Gregoretti, Cesare
Decaroli, Daniela
Piacevoli, Quirino
Mistretta, Alice
Barzaghi, Nicoletta
Luxardo, Nicola
Tosetti, Irene
Tedeschi, Luisa
Burbi, Laura
Navalesi, Paolo
Azzeri, Fabio


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