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General Anesthesia: Overview01:24

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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.
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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...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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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.
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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...
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Scheduling Anesthesia Time Reduces Case Cancellations and Improves Operating Room Workflow in a University Hospital

Elizabeth van Veen-Berkx1, Menno V van Dijk2, Diederich C Cornelisse3

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Implementing a new anesthesia-controlled time (ACT) scheduling method significantly reduced operating room (OR) prediction errors and cancellations. This optimized OR performance and workflow in a university hospital setting.

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Area of Science:

  • Anesthesiology
  • Healthcare Management
  • Operating Room Efficiency

Background:

  • A novel anesthesia-controlled time (ACT) scheduling method was introduced in an academic inpatient operating room (OR) department on July 1, 2012.
  • This method involved creating predefined time slots for anesthetic techniques based on historical anesthesia induction and emergence times.
  • Seven distinct anesthesia scheduling packages were developed, accounting for monitoring and patient complexity.

Purpose of the Study:

  • To evaluate the impact of the new ACT scheduling method on OR performance.
  • To determine the relationship between the implemented scheduling strategy and key performance indicators.

Main Methods:

  • A quasi-experimental time-series design was employed, analyzing data from 34,976 elective inpatient cases between January 1, 2010, and December 31, 2014.
  • Data were divided into four periods: pre-intervention and three post-intervention phases.
  • Analysis involved ANOVA with contrast analysis, excluding all emergency cases.

Main Results:

  • The intervention demonstrated a significant 4.5% reduction in prediction error (p < 0.001).
  • Operating room cancellations decreased by 19.9% following the implementation.
  • No significant differences were observed in under- or over-utilized OR time or raw OR usage.

Conclusions:

  • Accurate scheduling of anesthesia-controlled time (ACT) and surgeon-controlled time improves OR workflow.
  • The new scheduling method leads to reduced case cancellations and prediction errors.
  • This approach enhances operational efficiency within a university hospital setting.