Manual of Office-Based Anesthesia Procedures Manual of Office-Based Anesthesia Procedures FredE.Shapiro,DO Instructor-in-Anesthesia HarvardMedicalSchool DepartmentofAnesthesia,CriticalCareandPainMedicine BethIsraelDeaconessMedicalCenter Boston,Massachusetts AcquisitionsEditor:BrianBrown ManagingEditor:NicoleT.Dernoski ProjectManager:BridgettDougherty ManufacturingManager:KathleenBrown MarketingManager:AngelaPanetta DesignCoordinator:TerryMallon ProductionService:LaserwordsPrivateLimited,Chennai,India Printer:RRDonnelley-Crawfordsville 2007byLIPPINCOTTWILLIAMS&WILKINS,aWoltersKluwerbusiness 530WalnutStreet Philadelphia,PA19106USA LWW.com Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybe reproducedinanyformbyanymeans,includingphotocopying,orutilizedbyanyinformation storageandretrievalsystemwithoutwrittenpermissionfromthecopyrightowner,except forbriefquotationsembodiedincriticalarticlesandreviews.Materialsappearinginthis bookpreparedbyindividualsaspartoftheirofficialdutiesasU.S.governmentemployees arenotcoveredbytheabove-mentionedcopyright. CoverIllustrationbyFrankD.Fasano,MAMS,BFA PrintedintheUSA LibraryofCongressCataloging-in-PublicationData Manualofoffice-basedanesthesiaprocedures/[editedby]FredE.Shapiro. p.;cm. Includesbibliographicalreferencesandindex. ISBN-13:978-0-7817-6908-2 ISBN-10:0-7817-6908-6 1. Anesthesia—Handbooks,manuals,etc. 2. Anesthesiology—Practice—United States—Handbooks,manuals,etc. 3. Anesthesiology—Standards—United States—Handbooks,manuals,etc. 4. Ambulatorysurgery. I.Shapiro,FredE. [DNLM:1. Anesthesia—methods. 2. AmbulatorySurgicalProcedures. 3. Anesthesia—standards. 4. PracticeManagement,Medical. 5. Surgery,Plastic. WO200M29472007] RD82.2.M3542007 617.9(cid:1)6—dc22 2007008651 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresentedandtodescribe generallyacceptedpractices.However,theauthors,editors,andpublisherarenot responsibleforerrorsoromissionsorforanyconsequencesfromapplicationofthe informationinthisbookandmakenowarranty,expressedorimplied,withrespecttothe currency,completeness,oraccuracyofthecontentsofthepublication.Applicationofthis informationinaparticularsituationremainstheprofessionalresponsibilityofthe practitioner. 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VisitLippincottWilliams&WilkinsontheInternet:atLWW.com.LippincottWilliams& Wilkinscustomerservicerepresentativesareavailablefrom8:30amto6pm,EST. 10 9 8 7 6 5 4 3 2 1 Tomydearsister,Marcelle, Whotaughtmeasimplelifelesson: Knowledge,determination,andstrength Withkindness+health =achievementwithhappiness Contents Contributors ................................................................... ix Preface.......................................................................... xi Foreword....................................................................... xv Acknowledgments ............................................................. xvii 1. PrinciplesofOffice-BasedAnesthesia ................................ 1 E.CaleHendricksandFredE.Shapiro 2. TheStatistics............................................................ 6 JonathonRutkauskasandFredE.Shapiro 3. MembersoftheTeam................................................... 11 JonathonRutkauskasandFredE.Shapiro 4. TheAllureofanOffice.................................................. 13 JonathonRutkauskasandFredE.Shapiro 5. AmericanSocietyofAnesthesiologists’Guidelinesfor Office-BasedAnesthesiaPractices.................................... 16 RichardD.Urman 6. ThePreoperativeEvaluation .......................................... 29 RichardD.Urman,JonathanKaper,andFredE.Shapiro 7. AnesthesiaTechniques:WhichistheSafestChoice?............... 40 RichardD.UrmanandFredE.Shapiro 8. ClosedClaimsProject................................................... 52 KarinneM.Jervis,RichardD.Urman,andFredE.Shapiro 9. ChoosingAnestheticAgents.WhichOne?............................ 58 RichardD.UrmanandFredE.Shapiro 10. Monitors.................................................................. 75 AlexanderC.Gerhart 11. SurgicalProceduresintheOffice-BasedSetting.................... 89 D.JonathanBernardiniandFredE.Shapiro 12. OphthalmologyintheOffice........................................... 111 M.JacobKaczmarski 13. GastrointestinalEndoscopyintheOffice-BasedSetting........... 120 KaiMatthes 14. Post-BariatricSurgery:ANewBodyContour....................... 133 StephanieA.Caterson,KarinneJervis,andRichardD.Urman 15. Pain....................................................................... 139 CristinA.McMurray 16. AlternativePainControl............................................... 149 CristinA.McMurrayandFredE.Shapiro vii viii Contents 17. PostanesthesiaCareUnit—RecoveryandDischarge .............. 155 PankajK.Sikka Appendices..................................................................... 165 Index............................................................................ 187 Contributors D.JonathanBernardini,MD ClinicalFellow,Departmentof Anesthesia,HarvardMedicalSchool,ResidentinAnesthesia,Department ofAnesthesia,CriticalCare,andPainMedicine,BethIsraelDeaconess MedicalCenter,Boston,Massachusetts StephanieA.Caterson,MD ClinicalFellowinSurgery,Departmentof Surgery,BethIsraelDeaconessMedicalCenter,Boston,Massachusetts AlexanderGerhart ClinicalResident,DepartmentofAnesthesia,Critical Care,andPainMedicine,HarvardMedicalSchool,BethIsraelDeaconess MedicalCenter,Boston,Massachusetts E.CaleHendricks,MD ChiefResident,DepartmentofAnesthesia, CriticalCare,andPainMedicine,BethIsraelDeaconessMedicalCenter, Boston,Massachusetts KarinneM.Jervis,MD ClinicalFellowinAnesthesia,Departmentof Anesthesia,BethIsraelDeaconessMedicalCenter,Boston,Massachusetts M.JacobKaczmarski,MD ClinicalFellow,DepartmentofAnesthesia, HarvardMedicalSchool,ResidentinAnesthesiology,Departmentof Anesthesia,CriticalCare,andPainMedicine,BethIsraelDeaconess MedicalCenter,Boston,Massachusetts JonathanKaper,MD ClinicalFellowinAnesthesia,Departmentof Anesthesia,BethIsraelDeaconessMedicalCenter,Boston,Massachusetts KaiMatthes,MD ClinicalResident,DepartmentofAnesthesia,Critical Care,andPainMedicine,HarvardMedicalSchool,BethIsraelDeaconess MedicalCenter,Boston,Massachusetts CristinAngleyMcMurray,MD ClinicalFellow,Departmentof Anesthesia,HarvardMedicalSchool,Resident,DepartmentofAnesthesia, CriticalCare,andPainMedicine,BethIsraelDeaconessMedicalCenter, Boston,Massachusetts JonathonT.Rutkauskas,MD DepartmentofAnesthesiology,BethIsrael DeaconessMedicalCenter,Boston,Massachusetts PankajKumarSikka,MD,PhD Instructor,Departmentof Anesthesiology,PerioperativeandPainMedicine,HarvardMedical School,BrighamandWomen’sHospital,Boston,Massachusetts RichardD.Urman,MD Instructor-in-Anesthesia,Departmentof Anesthesiology,Perioperative,andPainMedicine,HarvardMedical School,AttendingAnesthesiologist,DepartmentofAnesthesiology, Perioperative,andPainMedicine,BrighamandWomen’sHospital, Boston,Massachusetts ix
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