Inhalational techniques in ambulatory anesthesia

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

In the current health care environment, anesthesia practitioners are frequently required to reevaluate their practice to be more efficient and cost-effective. Although IV induction with propofol and inhalational induction with sevoflurane are both suitable techniques for outpatients, patients prefer IV induction. Maintenance of anesthesia with the newer inhaled anesthetics (ie, desflurane and sevoflurane) provide for a rapid early recovery as compared with infusion of propofol (ie, TIVA), while allowing easy titratability of anesthetic depth. Titration of hypnotic sedatives using BIS monitoring may reduce the time to awakening and thereby may facilitate fast tracking (ie, bypassing the PACU) and reduce hospital stay. Inhalational anesthesia is associated with a higher incidence of PONV, but no differences have been demonstrated with respect to late recovery (eg, PACU stay and home readiness). Although clinical differences between desflurane and sevoflurane appear to be small, desflurane may be associated with faster emergence, particularly in elderly and morbidly obese patients. Balanced anesthesia with IV propofol induction and inhalation anesthesia with N2O for maintenance, and an LMA for airway management, may be an optimal technique for ambulatory surgery. Inhalational anesthesia may have an economic advantage over a TIVA technique.

Original languageEnglish (US)
Pages (from-to)263-272
Number of pages10
JournalAnesthesiology Clinics of North America
Volume21
Issue number2
DOIs
StatePublished - Jun 2003

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Propofol
Anesthesia
Anesthetics
Balanced Anesthesia
Maintenance
Inhalation Anesthesia
Postoperative Nausea and Vomiting
Airway Management
Hypnotics and Sedatives
Ambulatory Surgical Procedures
Length of Stay
Outpatients
Economics
Delivery of Health Care
Costs and Cost Analysis
Incidence
desflurane
sevoflurane

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Inhalational techniques in ambulatory anesthesia. / Joshi, Girish P.

In: Anesthesiology Clinics of North America, Vol. 21, No. 2, 06.2003, p. 263-272.

Research output: Contribution to journalArticle

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