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High turnover for ambulatory orthopedic surgery
Ali Shariat1, Berend Marcus2, Malikah Latmore1
1Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside Medical Center, New York, New York, USA.
Purpose Of Review:
The trend in the perioperative management of patients having orthopedic surgery in the ambulatory setting emphasizes time-efficiency and rapid turnovers. Anesthetic techniques and management continue to evolve to increase efficiency and decrease time spent in recovery.
Recent Findings:
Minimizing time patients spend in phase 1 recovery or bypassing phase 1 altogether, known as fast-tracking, has become an important goal in containing costs in high turnover, ambulatory settings. Anesthetic techniques, particularly implementation of regional anesthesia and multimodal analgesia, have evolved to maximize efficiency.
Summary:
Anesthetic goals in the setting of high-turnover orthopedic surgery include effective multimodal analgesia, decreasing monotherapy with opioids, and patient education. Regional anesthesia as part of a multimodal analgesic regimen is increasingly used in ambulatory surgery fast-tracking protocols.
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