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2007, Number S1

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Rev Mex Anest 2007; 30 (S1)

Fast-tracking anesthetic techniques

White PF

Language: English
References: 32
Page: 30-32
PDF size: 49.40 Kb.


Text Extraction

The ability to deliver a safe and effective anesthetic with minimal side effects and a rapid recovery is mandatory for “fast tracking” patients after surgery(1). Interest in facilitating the recovery process following anesthesia has led to controversies regarding the optimal anesthetic technique (e.g., local vs regional vs general), as well as the best types of anesthetic drugs (e.g., volatile, intravenous, muscle relaxant, local anesthetic, sympatholytic). Intravenous (IV) drugs remain popular for sedation, as well as induction of anesthesia, because of their ease of administration, rapid onset of action and recovery, and high patient acceptance. However, volatile (inhaled) anesthetics are more popular for maintenance of anesthesia because of the ease in titrating to an adequate depth of anesthesia during surgery. In addition, early recovery after general anesthesia can be facilitated by using a combination of nitrous oxide (N2O), volatile anesthetics with low blood: gas partition coefficients (e.g., desflurane or sevoflurane), and short-acting sympatholytic drugs (e.g., remifentanyl, esmolol, dexmedetomidine). The pre-emptive use of local anesthetics and non-opioid analgesics for prevention of pain, and antiemetic drugs for prophylaxis against postoperative nausea and vomiting is also critical to the success of a fast-tracking general anesthetic technique.


REFERENCES

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  2. Cheng DC. Fast-track cardiac surgery: economic implications in postoperative care. J Cardiothorac Vasc Anesth 1998;12:72-9.

  3. Cheng DC, Wall C, Djaiani G, et al. Randomized assessment of resource use in fast-track cardiac surgery 1-year after hospital discharge. Anesthesiology 2003;98: 651-7.

  4. Mora CT, Dudek C, Torjman MC, White PF. The effects of anesthetic technique on the hemodynamic response and recovery profile in coronary revascularization patients. Anesth Analg 1995;81:900-10.

  5. Latham P, Zárate E, White PF, et al. Fast-track cardiac anesthesia: A comparison of remifentanyl plus intrathecal morphine with sufentanyl in a desflurane-based anesthetic. J Thorac Vasc Anesth 2000;14:645-51.

  6. Myles PS, Daly DJ, Djaiani G, et al. A systematic review of the safety and effectiveness of fast-track cardiac anesthesia. Anesthesiology 2003;99:982-7.

  7. Tang J, Chen L, White PF, et al. Recovery profile, costs, and patient satisfaction with propofol and sevoflurane for fast-track office-based anesthesia. Anesthesiology 1999;91:253-261.

  8. Tang J, Chen L, White PF, et al. A use of propofol for office-based anesthesia: effect of nitrous oxide on recovery profile. J Clin Anesth 1999;11:226-30.

  9. Coloma M, Chiu JW, White PF, et al. Fast-tracking after immersion lithotripsy: general anesthesia versus monitored anesthesia care. Anesth Analg 2000;91:92-6.

  10. Tang J, White PF, Wender RH, et al. Fast-track office-based anesthesia: A comparison of propofol versus desflurane with antiemetic prophylaxis in spontaneously breathing patients. Anesth Analg 2001;92:95-9.

  11. White PF. [Editorial] Prevention of nausea and vomiting: A multimodal solution to a persistent problem. N Engl J Med 2004;350:2511-2.

  12. White PF. The role of non-opioid analgesic techniques in the management of pain after ambulatory surgery. Anesth Analg 2002;94:577-85.

  13. Song D, Greilich NB, White PF, et al. Recovery profiles and costs of anesthesia for outpatient unilateral inguinal herniorrhaphy. Anesth Analg 2000;91:876-81.

  14. Li S, Coloma M, White PF, et al. Comparison of the costs and recovery profiles of three anesthetic techniques for ambulatory anorectal surgery. Anesthesiology 2000:93:1225-30.

  15. Kehlet H, White PF. Optimizing anesthesia for inguinal herniorrhaphy: General, regional, or local anesthesia? Anesth Analg 2001;93:1367-9.

  16. Sa Régo M, Watcha MF, White PF. The changing role of monitored anesthesia care in the ambulatory setting. Anesth Analg 1997;85:1020-36.

  17. Song D, Joshi GP, White PF. Fast-track eligibility after ambulatory anesthesia: A comparison of desflurane, sevoflurane, and propofol. Anesth Analg 1998;86:267-73.

  18. Song D, White PF. Remifentanyl as an adjuvant during desflurane anesthesia facilitates early recovery after ambulatory surgery. J Clin Anesth 1999;11:364-7.

  19. Song D, Whitten CW, White PF. Remifentanyl infusion facilitates early recovery for obese outpatients undergoing laparoscopic cholecystectomy. Anesth Analg 2000;90:1111-3.

  20. Fredman B, Sheffer O, Zohar, et al. Fast-track eligibility of geriatric patients undergoing short urologic surgery procedures. Anesth Analg 2002;94:560-4.

  21. Coloma M, Zhou T, White PF, et al. Fast-tracking after outpatient laparoscopy: Reasons for failure after propofol, sevoflurane and desflurane anesthesia. Anesth Analg 2001;93:112-5.

  22. Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology 1997;87:842-8.

  23. Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanyl, and nitrous oxide anesthesia. Anesthesiology 1997;87:808-15.

  24. Song D, Van Vlymen J, White PF. Is the bispectral index useful in predicting fast-track eligibility after ambulatory anesthesia with propofol and desflurane? Anesth Analg 1998;87:1245-8.

  25. White PF, Ma H, Tang J, et al. Does the use of electroencephalographic bispectral index or auditory evoked potential index monitoring facilitate recovery after desflurane anesthesia in the ambulatory setting? Anesthesiology 2004;100:811-7.

  26. van Vlymen JM, Sá Rêgo MM, White PF. Benzodiazepine premedication: can it improve outcome in patients undergoing breast biopsy? Anesthesiology 1999;90:740-7.

  27. Chia YY, Chan MH, Ko NH, Liu K. Role of b-blockade in anaesthesia and postoperative pain management after hysterectomy. Br J Anaesth 2004;93:799-805.

  28. Coloma M, Duffy LL, White PF, et al. Dexamethasone facilitates discharge after outpatient anorectal surgery. Anesth Analg 2001;92:85-8.

  29. Bisgaard T, Klarskov B, Kehlet H, Rosenberg J. Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy. A randomized double-blind placebo-controlled trial. Ann Surg 2003;238:651-60.

  30. White PF. [Editorial] Changing role of COX-2 inhibitors in the perioperative period: is parecoxib really the answer? Anesth Analg 2005;100:1306-8.

  31. White PF. [Editorial] Choice of peripheral nerve block for inguinal herniorrhaphy: is better the enemy of good? Anesth Analg 2006;102:1073-5.

  32. White PF, Kehlet H, Neal JM, Schricker T, Carr DB, Carli F. Role of the Anesthesiologist in Fast-track Surgery: From Multimodal Analgesia to Perioperative Medicine. Anesth Analg 2006 (in press).




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