Jeff Cryder, CRNA
ANESTHESIA ALERT
2 6
O U T P AT 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 | N O V E M B E R 2 0 1 4
4 Keys to My Anesthesia Technique
My patients wake up faster with less pain and fewer complications.
I
f you're looking to save
money on anesthesia,
your technique can be just
as important as the machine
you buy. I've been refining
my technique over the last
several years. I believe it
saves my hospital thousands
of dollars.
Choice of gas.
I almost
always use desflurane
instead of sevoflurane,
including when I use LMAs
for my anesthetic. Some do
just the opposite, and it's true
that desflurane costs a little
more per bottle. But it can
save in the long run, because
it allows for lower flows and
quicker recovery, and it's more forgiving. With sevoflurane, the manu-
facturer recommendation is not to exceed 2 MAC hours with fresh
flows between 1 to < 2 L/min, or to run flows below 1 L/min.
Otherwise, patients may be exposed to Compound A, which can dam-
age kidneys. To my knowledge, desflurane doesn't have a minimum
flow rate. I typically run fresh gas at 0.6 L/min, which, based on my
research, makes it about one-third as expensive as sevoflurane, per
minute.
1
Pamela
Bevelhymer,
RN,
BSN
TIME-TESTED APPROACH Understanding
and optimizing the many variables involved in
anesthesia can improve the bottom line.
