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A I R W A Y
M A N A G E M E N T
3
Anesthetists in the ambulatory setting are constantly thinking about how
to administer the least amount of IV
Can intubation be
avoided?
For surgery taking place outside
of the airway, efficiency-minded anes-
anesthesia possible, and what anesthesia technique would allow them a
thesia providers are always calculat-
natural airway option. In the best-case
ing whether the case can be done
scenario, the local anesthetic or
without intubation. Sometimes it can't
peripheral nerve block (delivered as a
be avoided: In tonsillectomy cases
single shot or through a continuous
there's going to be blood, and there's
catheter) can manage a patient's pain
no way a nasal trump, oral airway or
through discharge, which will necessi-
laryngeal mask airway (LMA) can be
tate less post-op narcotics and create
used when the surgeon's working in
less risk of PONV, respiratory depres-
the airway. But in the interest of quick
sion and prolonged stays in recovery.
throughput, always consider whether
an endotracheal tube (ET) can be
The selection of anesthesia for a
avoided.
case may be a matter of surgeon
The ultimate goal of airway manage-
preference, so a good working rela-
ment is extubation and spontaneous
tionship between your anesthesia
providers and surgeons — and
WALKING PAPERS Ambulatory
anesthesia and efficient airway
management contribute to speedy
discharges and happy patients.
an awareness of what each is
capable of — can pay off.
While some physicians may
express concerns over working on conscious patients, you
might find out many are open
sia to improve efficient
throughput.
4 0
Rosalind Ritchie, MD
to the idea of regional anesthe-
SUPPLEMENT
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O U T PAT I E N T S U R G E R Y M A G A Z I N E | J U LY 2013
