Risks of anesthesia or sedation outside the operating room: the role of the anesthesia care provider.
نویسندگان
چکیده
PURPOSE OF REVIEW Our goal is to review the recent year's novel and relevant literature on the practice of sedation/anesthesia in the nonoperating room setting. Risk factors and outcomes were evaluated related to locations, providers, and anesthetic regimens. RECENT FINDINGS Administration of sedation/anesthesia for patients undergoing uncomfortable or painful interventions outside the operating room is an expanding practice involving a wide variety of practitioners. With a growing emphasis on cost, efficiency, and patient satisfaction, propofol alone or in combination with other sedatives/analgesics has become popular for procedural sedation among nonanesthesiologists. Although major adverse events are rare in this setting, potentially risky complications, such as respiratory depression and desaturation, still occur and their importance cannot be neglected. In this context, the American Society of Anesthesiologists Closed Claims and the Pediatric Sedation Research Consortium databases convey some valuable data. The bulk of reported complications are related to anesthetic drug-induced respiratory depression or airway obstruction leading to hypoxemia or hypoventilation. There are several new studies highlighting the importance of capnography in detecting impending airway or respiratory adverse events. SUMMARY The current incidence of complications associated with sedation in the nonoperating room environment remains irresolute. Although there are many studies on sedation practices in the out-of-operating room setting, high-quality studies are lacking. There are no data comparing practice outcomes between different practitioners and specialties.
منابع مشابه
Anesthesia and sedation outside of the operating room
The volume of pediatric invasive and noninvasive procedures outside the operating room continues to increase. The acuity and complexity of patient clinical condition has resulted in the expansion of the anesthesiologist's role in remote sites. The anesthesia provider must ensure patient safety by assuring appropriate patient preparation, having available required equipment for monitoring and re...
متن کاملStandardizing care and monitoring for anesthesia or procedural sedation delivered outside the operating room.
PURPOSE OF REVIEW The purpose of this review is to summarize recommendations for the safe and efficient conductance of sedation and anesthesia at remote locations; and to define safety standards, monitoring techniques, quality of care and procedural eligibility. RECENT FINDINGS Anesthesia outside of the operating room is rapidly increasing in numbers, which has seen a growth of older and sick...
متن کاملIncidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium.
OBJECTIVE We sought to use a large database of prospectively collected data on pediatric sedation and/or anesthesia for diagnostic and therapeutic procedures to delineate the nature and the frequency of adverse events that are associated with sedation/anesthesia care for procedures that are performed outside the operating room in children. METHODS Data were collected by the Pediatric Sedation...
متن کاملMonitored anesthesia care in and outside the operating room
Monitored anesthesia care (MAC) is an anesthesia technique combining local anesthesia with parenteral drugs for sedation and analgesia. The use of MAC is increasing for a variety of diagnostic and therapeutic procedures in and outside of the operating room due to the rapid postoperative recovery with the use of relatively small amounts of sedatives and analgesics compared to general anesthesia....
متن کاملThe incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium.
OBJECTIVE We used a large database of prospectively collected data on pediatric sedation/anesthesia outside the operating room provided by a wide range of pediatric specialists to delineate the nature and frequency of adverse events associated with propofol-based sedation/anesthesia care. PATIENTS AND METHODS Data were collected by the Pediatric Sedation Research Consortium, a collaborative g...
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عنوان ژورنال:
- Current opinion in anaesthesiology
دوره 23 4 شماره
صفحات -
تاریخ انتشار 2010