By Michael Lavan R.N., Judy Swanson R.N., Andrea Ferrara M.D. (auth.), H. Randolph Bailey M.D., Michael J. Snyder M.D. (eds.)
Ambulatory Anorectal Surgery is a undemanding reference on all points of office-based anorectal surgical procedure for training common surgeons and surgeons in education. Well-illustrated, this useful guide exhibits step by step methods for: - Hemorroidectomy - fix of anal fissures - upkeep of Fistula in-ano - Colonoscopy - Pilondial cyst. The textual content comprises ancillary issues of ambulatory surgical procedure with well timed chapters on set-up of the power, anesthesic issues, number of sufferers, pre-op and post-op administration, nursing facets, and coding and billing. A needs to for all basic surgeons.
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Extra resources for Ambulatory Anorectal Surgery
After an initial dose of 1 to 2 mg/kg, patients can be kept lightly asleep but easily arousable by a continuous infusion of 3 to 4 mg/kg per hour. Propofol may have an advantage over other sedation techniques because of the ease with which the infusion can be increased, and the anesthetic management can be converted to a general anesthetic from which awakening will be rapid. 7). In addition, the quality of the regional block is dependent to a certain extent on the skill of the person performing the block.
The other potential side effects of succinylcholine are an increase in the intraocular pressure, malignant hyperthermia, and hyperkalemia. 5 For short procedures, mivacurium or atracurium is often used. The major side effect of both of these neuromuscular blocking agents is the release of histamine. Therefore, the author's personal preference is to use a small dose of vecuronium. In the ambulatory surgery center it is critical to avoid life-threatening anaphylactic reactions. Maintenance: Narcotics and Isoflurane Traditional maintenance-phase anesthesia consists of a combination of an inhalation agent and a narcotic.
In an endoscopy unit where the procedure volume is very low, the significant cost of a manual processor can be avoided by purchasing a special soaking pan at a very low cost and using a kitchen timer to regulate the time of exposure to the disinfectant. The scope is loaded into the automatic processor according to the manufacturer's recommendations to allow for exposure of all surfaces and working channels to the disinfectant. Most new units can accommodate any of the EPA-approved high-level disinfectant solutions currently available.
Ambulatory Anorectal Surgery by Michael Lavan R.N., Judy Swanson R.N., Andrea Ferrara M.D. (auth.), H. Randolph Bailey M.D., Michael J. Snyder M.D. (eds.)