Safety and Efficacy of Office-Based Surgery with Monitored Anesthesia Care/Sedation in 4778 Consecutive Plastic Surgery Procedures
| Autor: | Kevin P. Smith, William Jacobs, David E. Matthews, Stanley E. Getz, Paul Watterson, Peter J. Capizzi, George Bitar, William F. Mullis, Felmont F. Eaves, Michael E. Beasley |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Sedation Outpatient surgery Conscious Sedation Anesthesia General Monitoring Intraoperative medicine Humans Local anesthesia Surgery Plastic Child Aged Nurse Anesthetists Retrospective Studies Aged 80 and over business.industry Nurse anesthetist Middle Aged Ambulatory Surgical Procedure Plastic surgery Ambulatory Surgical Procedures Child Preschool Anesthesia Postoperative Nausea and Vomiting Midazolam Female Surgery Safety medicine.symptom business business.employer Postoperative nausea and vomiting medicine.drug |
| Zdroj: | Plastic and Reconstructive Surgery. 111:150-156 |
| ISSN: | 0032-1052 |
| DOI: | 10.1097/01.prs.0000037756.88297.bc |
| Popis: | Office-based surgery has several potential benefits over hospital-based surgery, including cost containment, ease of scheduling, and convenience to both patients and surgeons. Scrutiny of office-based surgery by regulators and state-licensing agencies has increased and must be addressed by improved documentation of safety and efficacy. To evaluate the safety and efficacy of the authors' office-based plastic surgery, a review was undertaken of 3615 consecutive patients undergoing 4778 outpatient plastic surgery procedures under monitored anesthesia care/sedation in a single office. The charts of 3615 consecutive patients who had undergone office-based surgery with monitored anesthesia care/sedation between May of 1995 and May of 2000 were reviewed. In all cases, the anesthesia protocol used included sedation with midazolam, propofol, and a narcotic administered by a board-certified registered nurse anesthetist with local anesthesia provided by the surgeon. Charts were reviewed for patient profile, types of procedures, multiple procedures, duration of anesthesia, American Society of Anesthesiologists class, and complications related to anesthesia. Outcomes measured included death, airway compromise, dyspnea, hypotension, venous thrombosis, pulmonary emboli, protracted nausea and vomiting lasting more than 24 hours, and unplanned hospital admissions. Statistical analyses were performed using the Microsoft Excel program and the SAS package. Results were as follows: 92.3 percent of the patients were female and 7.7 percent were male, with a mean age of 42.7 years (range, 3 to 83 years). Patients underwent aesthetic (95.6 percent) and reconstructive (4.4 percent) plastic surgery procedures. Same-session multiple procedures occurred in 24.8 percent of patients. The vast majority of patients were healthy: 84.3 percent of patients were American Society of Anesthesiologists class I, 15.6 percent were class II, and 0.1 percent were class III. The operations required a mean of 111 minutes. There were no deaths, ventilator requirements, deep venous thromboses, or pulmonary emboli. Complications were as follows: 0.05 percent (n = 2) of patients had dyspnea that resolved, 0.2 percent (n = 6) of patients had protracted nausea and vomiting, and 0.05 percent (n = 2) of patients had unplanned hospital admissions ( |
| Databáze: | OpenAIRE |
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