Related Experiment Video
Updated: May 7, 2026
05:39
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
2.8K
Regional anesthesia and ambulatory surgery
Jeffrey G Moore1, Scott M Ross, Brian A Williams
1aDepartment of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Current Opinion in Anaesthesiology
|October 12, 2013
Summary
Regional anesthesia and multimodal care enable same-day discharge for ambulatory surgery. This approach, focusing on recovery criteria, reduces costs and improves patient recovery times.
Area of Science:
- Anesthesiology
- Surgical Recovery
- Regional Anesthesia
Background:
- Surgical and anesthetic advancements facilitate outpatient procedures.
- Meeting recovery criteria is key for ambulatory surgery benefits.
- Rising healthcare costs necessitate efficient patient discharge strategies.
Purpose of the Study:
- To review regional anesthesia techniques for outpatient orthopedics.
- To discuss multimodal strategies for enhanced recovery.
- To highlight the role of recovery criteria in optimizing ambulatory surgery.
Main Methods:
- Focus on regional anesthesia techniques, including ultrasound-guided blocks.
- Integration of multimodal approaches for postoperative nausea, vomiting, and pain management.
- Utilizing sedation-hypnosis and avoiding specific anesthetic agents.
Main Results:
- Ultrasound guidance enhances anesthesiologist confidence in performing blocks.
- Improved anesthetic depth monitoring allows for better sedative titration.
- Avoidance of certain volatile anesthetics and short-acting opioids is beneficial.
Conclusions:
- Routine regional anesthesia, multimodal prophylaxis, and analgesia facilitate Phase 1 postanesthesia care unit bypass.
- Expedited same-day discharge is achievable with suitable recovery criteria.
- Optimizing anesthetic plans with multimodal care supports efficient ambulatory surgery.
Related Concept Videos
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
2.2K
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
2.2K
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
2.0K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
2.0K
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
2.9K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
2.9K
01:24General Anesthesia: Overview
1.1K
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
1.1K
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
1.1K
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
1.1K
01:13Local Anesthetics: Pharmacokinetics
1.6K
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
1.6K