Clarence J. Biddle, CRNA, expects genomics to emerge as a key fac-
tor in drug administration, by deciphering the unique genetics of each
patient and determining how to best promote pain relief with minimal
side effects. The future will also bring monitoring platforms that are
worn throughout the pre-operative course, to "provide valuable
patient safety information," says Mr. Biddle, a professor and staff
anesthetist in the departments of anesthesiology and nurse anesthesia
at Virginia Commonwealth University Medical Center in Richmond,
Va. He also expects to see less cumbersome cerebral oxygenation
monitors "that provide more complete, real-time information about
tissues deep within the organ," and a "redesign of the anesthesia
workstation to decrease the risk of contamination and nosocomial
infection."
Mike MacKinnon, CRNA, co-owner of ce2you.com, an ultrasound
and vascular regional anesthesia company in Show Low, Ariz., sees
articulating video scopes for easier tube placement in his crystal ball,
along with refined, less-invasive hemodynamic and oxygen monitors,
"further removing risk in a specialty that already nearly enjoys Six
Sigma safety."
Continued outpatient migration
Advances in technology and pain management will in turn let a
greater number of patients safely have procedures without hospital
stays, says anesthesiologist Jeffrey Cazier, MD, who practices in
Huntsville, Ala. It all comes down to "increased safety and efficacy"
and "evidence-based, standardized protocols," says Dr. Cazier.
Mr. MacKinnon also expects the doors to outpatient centers to be
swinging open more often, with more challenging cases, like total
knees, becoming the norm at 23-hour stay surgical centers.
No question, says Dr. Hickman. "The growth of outpatient total
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