Outpatient Surgery Magazine

Ambulatory Anesthesia Supplement - July 2013

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/140227

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Page 44 of 58

Ambulatory_Anesthesia_2013_Layout 1 6/26/13 2:21 PM Page 45 P O S T- O P M A N A G E M E N T of potential risk. cotics and have a In addition to history of PONV — statistically young, female, non- speaking, the smoking, narco- patients most tized patients, indi- likely to suffer it? viduals with a his- That's not a great tory of motion sick- way to run a sur- ness are also fre- gical facility, how- quently at risk. ever. So instead Using my aptly focus on proven named "Sinha's ways to reduce Indirect test of incidence of PONV from the KNOW AND GO Pre-op assessments often provide clues to patients' susceptibility to PONV. Motion Sickness" (a.k.a. "SIMS"), I'll ask patients if they moment patients enter your facility to when they're enjoy theme-park rides. The popula- heading home after surgery. tion cleanly divides into those who Pre-op precautions love them ("SIMS negative") and those It's reasonable to assume that, for who hate them ("SIMS positive"), with patients, the only thing worse than suf- very little middle ground. I've found fering PONV is not expecting it as a that "SIMS positive" patients are prob- possible outcome. In the interest of ably at a higher risk of PONV. keeping patients informed and pre- Granted, this is entirely anecdotal and pared, candidly discuss the potential based on personal observation. But it's problem during pre-op assessment a fairly accurate test that lets you be interviews. Mention that it's the most more proactive with a potentially common significant side effect of anes- high-risk group. thesia (about 30% of surgical patients Consider giving at-risk patients a reportedly suffer PONV). Then ask scopolamine patch or aprepitant patients to help you identify their level (Emend) tablets pre-operatively. J U LY 2013 | S U P P L E M E N T TO O U T PAT I E N T S U R G E R Y M A G A Z I N E 4 5

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