Outpatient Surgery Magazine

The Great Prepping Debate - December 2012 - Outpatient Surgery Magazine

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

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OSE_1212_part2_Layout 1 12/5/12 9:52 AM Page 98 ever possible and titrate any opioids to make the patient comfortable, not to achieve a particular pain score. Balance the degree of pain with concerns about sedation and respiratory depression. Regional blocks can be placed postop to provide safer, long-lasting pain relief. Monitor the patient in PACU until he is completely awake and maintains SaO2 at baseline. Exercise caution in OSA patients who develop prolonged and frequent severe respiratory events (such as sedation/ analgesic mismatch, desaturation, and hyponeic or apneic episodes) in the post-operative period. Most adverse events occur within 2 hours after surgery, so keeping close watch is of particular import. Ask patients placed on an OSA protocol based on clinical indicators to follow up with their primary physicians for a possible sleep study. Instruct patients on pre-operative CPAP that they should use CPAP when sleeping, daytime or nighttime. Finally, tell OSA patients to avoid opioids if possible, and not to take sedatives and/or muscle relaxants. OSM Dr. Joshi (girish.joshi@utsouthwestern.edu) is 9 8 O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2012

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