Maximization of Non-Opioid Multimodal Analgesia in Ambulatory Surgery Centers.

Autor: Charipova K; Medicine, MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington D.C., USA., Gress KL; Medicine, MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington D.C., USA., Urits I; Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA., Viswanath O; Anesthesiology, University of Arizona College of Medicine, Phoenix, USA., Kaye AD; Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, USA.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2020 Sep 12; Vol. 12 (9), pp. e10407. Date of Electronic Publication: 2020 Sep 12.
DOI: 10.7759/cureus.10407
Abstrakt: Ambulatory surgery centers aid the healthcare system by not only providing a cost-effective option for delivery of care but also by helping to reduce overwhelming case volumes at inpatient facilities. While outpatient protocols have been designed for an increasing number of surgical procedures, the inpatient to outpatient transition of surgery remains limited by both procedure type and patient comorbidities. This limitation stems in part from the heavy emphasis on accelerated discharge following outpatient procedures, given that prolonged recovery time is associated with delayed turnover and increased nursing care demands. Since its inception, enhanced recovery after surgery (ERAS) has aimed to primarily reduce the disruption of physiologic homeostasis that occurs secondary to surgery. More recently, the aim of ERAS has evolved to help transition inpatient procedures to outpatient settings and may even be useful in more emergent cases. It should be noted, however, that outpatient surgery even in combination with ERAS is not the best option for all patients, and the use of ERAS protocols should be complemented with predictive assessments of patient risk. Beyond augmenting the efficiency of outpatient surgery, ERAS protocols, when used in eligible patients and especially when combined with regional anesthetic techniques, are effective in delivering opioid-sparing pain management while increasing overall outcomes and patient satisfaction rates.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2020, Charipova et al.)
Databáze: MEDLINE