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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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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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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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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...
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Local Anesthetics: Pharmacokinetics01:13

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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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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Changing Anesthesia Block Allocations Improves Endoscopy Suite Efficiency.

Mitchell H Tsai1,2,3, Michael A Hall4, Melanie S Cardinal5

  • 1Department of Anesthesiology, University of Vermont Larner College of Medicine, Burlington, VT, USA. Mitchell.Tsai@uvmhealth.org.

Journal of Medical Systems
|November 20, 2019
PubMed
Summary
This summary is machine-generated.

Individual anesthesia block scheduling in endoscopy suites significantly improved efficiency. This shift from shared blocks to provider-specific allocations enhanced elective time utilization and boosted productivity, demonstrating advantages for non-operating room anesthesia (NORA) settings.

Keywords:
EndoscopyNon-operating room anesthesiaSchedulingStatistical process controlTactical decisionsUnder-utilized time

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Area of Science:

  • Anesthesiology
  • Healthcare Management
  • Health Services Research

Background:

  • Non-operating room anesthesia (NORA) is a growing sector of anesthesia practice.
  • Optimizing resource utilization in NORA settings requires effective scheduling paradigms.
  • Traditional operating room anesthesia scheduling may not be directly transferable to NORA environments.

Purpose of the Study:

  • To investigate the impact of shifting from shared to individual anesthesia block allocations in an endoscopy suite.
  • To assess the effect of this scheduling change on operational efficiency and clinical productivity.
  • To determine if individual block allocation improves resource utilization in NORA settings.

Main Methods:

  • A retrospective and prospective analysis was conducted at an academic hospital.
  • The study focused on adult patients undergoing elective endoscopy procedures.
  • Key metrics included elective time-in-block, time-out-of-block, under-utilized time, over-utilized time, and case tardiness.

Main Results:

  • Elective time in block increased by 156% (p < 0.0001), while elective time out of block decreased by 38% (p < 0.0001).
  • Opportunity unused time reduced by 28% (p < 0.0001), and productivity rose by 51% (p < 0.0001).
  • Over-utilized time and case tardiness did not change significantly.

Conclusions:

  • Individual anesthesia block allocation in GI endoscopy settings offers advantages over traditional shared block systems.
  • This scheduling approach enhances operational efficiency and clinical productivity in NORA environments.
  • Further research into NORA scheduling practices and their impact on financial productivity is warranted.