establish an adequate line before the patient reaches the OR.
Otherwise, administering emergency drugs becomes a challenge.
Calculate the medications and dosages you'll need to ensure a suc-
cessful recovery without compounding respiratory issues that are
already likely to be present.
When intubating obese patients, succinylcholine should be the relaxant
of choice, says Mr. Ruspantine, due to its rapid onset and short duration.
When a neuromuscular blocking agent is used, sugammadex is the rever-
sal agent of choice, over neostigmine, he adds. It allows for a much safer
and faster recovery and has fewer potential side effects. The chance that
recurarization will occur is also far lower with sugammadex.
Desflurane is the best choice for an inhalation agent. Its low solubility
leads to less distribution in the fat tissue, which permits faster emer-
gence. Induction is
slower than with
sevoflurane or isoflu-
rane, but faster emer-
gence helps make up
for that lost time.
Regardless of the
anesthetic or tech-
nique, the goal should
be to minimize respi-
ratory depression and
limit post-op sedation,
which may cause
excessive oxygen con-
sumption.
Remember these
best bets for avoiding
1 0 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 6
