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4. Pharmacologic aids
It was a long time coming
for sugammadex, which
was sold in Europe for a
full 6 years before the
FDA finally gave the agent
its stamp of approval in
2015, but it's quickly
become a welcome addi-
tion to the anesthesia
arsenal, says Mike
McKinnon, CRNA, a part-
ner in a CRNA-only practice in Show Low, Ariz. The drug reverses the effects of
the muscle relaxants rocuronium and vecuronium, so if a case finishes more
quickly than expected, or an anesthesia provider administers more paralytic than
was needed, you'll spend less time waiting for the drugs to wear off.
"The big benefit is a faster return to spontaneous ventilation," says Mr.
MacKinnon. "That translates into faster room turnovers, because you're not sit-
ting around in the OR for an extra 5 to 10 minutes, waiting for the patient to be
reversed."
Antiemetics like ondansetron and NSAIDs like ketorolac are also "allowing for
more effective treatment and faster discharge," says Dr. Reines.
5. Supraglottic airways
If you aren't using supraglottic airways in a majority of outpatient cases, you
may be missing an opportunity to improve efficiency, says Dr. Reines. They
aren't appropriate for every patient or every procedure, but patients typically
tolerate the airways much better than they do endotracheal tubes. That allows
for lower levels of anesthesia and faster emergence with fewer complications.
Which patients are appropriate and which aren't?
• HELPFUL TOOL Supraglottic airways allow for lower levels of anesthesia and faster
emergence, which are keys to maintaining efficiencies in the outpatient setting.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
