Revisiones_bibliográficas TyO_Web: Anestesia ambulatoria / Ambulatory anesthesia

lunes, 11 de septiembre de 2017

Anestesia ambulatoria / Ambulatory anesthesia

Septiembre 11, 2017. No. 2808

Anestesia para cirugía ambulatoriaAnesthesia for ambulatory surgery.
Lee JH1.
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Korean J Anesthesiol. 2017 Aug;70(4):398-406. doi: 10.4097/kjae.2017.70.4.398. Epub 2017 May 19.
Abstract
Ambulatory anesthesia allows quick recovery from anesthesia, leading to an early discharge and rapid resumption of daily activities, which can be of great benefit to patients, healthcare providers, third-party payers, and hospitals. Recently, with the development of minimallyinvasive surgical techniques and short-acting anesthetics, the use of ambulatory surgery has grown rapidly. Additionally, as the indications for ambulatory surgery have widened, the surgical methods have become more complex and the number of comorbidities has increased. For successful and safe ambulatory anesthesia, the anesthesiologist must consider various factors relating to the patient. Among them, appropriate selection of patients and surgical and anesthetic methods, as well as postoperative management, should be considered simultaneously. Patient selection is a particularly important factor. Appropriate surgical and anesthetic techniques should be used to minimize postoperative complications, especially postoperative pain, nausea, and vomiting. Patients and their caregivers should be fully informed of specific care guidelines and appropriate responses to emergency situations on discharge from the hospital. During this process, close communication between patients and medical staff, as well as postoperative follow-up appointments, should be ensured. In summary, safe and convenient methods to ensure the patient's return to function and recovery are necessary.
KEYWORDS: Ambulatory surgical procedures; Anesthesia; Patient safety; Patient selection
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La seguridad del paciente durante sedación mediante monitorización de capnografía: una revisión sistemática y meta-análisis.

Patient safety during procedural sedation using capnography monitoring: a systematic review and meta-analysis.

Saunders R1,2, Struys MMRF3,4, Pollock RF2, Mestek M5, Lightdale JR6,7.

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BMJ Open. 2017 Jun 30;7(6):e013402. doi: 10.1136/bmjopen-2016-013402.

Abstract

OBJECTIVE: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone.

CONCLUSIONS: Meta-analysis of 13 RCTs published between 2006 and 2016 showed a reduction in respiratory compromise (from respiratory insufficiency to failure) during PSA with the inclusion of capnography monitoring. In particular, use of capnography was associated with less mild and severe oxygen desaturation, which may have helped to avoid the need for assisted ventilation.

KEYWORDS: Ambulatory surgery; Capnography; Meta-analysis; Procedural sedation

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