Advertisement

Anesthesia outside the operating room

  • Steven C. Hall

Abstract

The provision of anesthetic services outside the traditional operating room environment is a challenge to both the adaptability and sensibility of the anesthesiologist. In an effort to increase the comfort and safety of patients and to assist other physicians, we are increasingly asked to provide services for a variety of diagnostic and therapeutic procedures. These services are variably called “anesthesia” or “sedation” or “monitored anesthesia care” (MAC). No matter what the service is called, the basic principle is that the anesthesiologist is entrusted to provide the best in patient care, no matter what drugs or techniques we use.

Keywords

Operating Room Lead Wire Anesthesia Machine Monitor Anesthesia Care Monitor Anesthesia Care 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ehrenwerth J, Eisenkraft JB. Anesthesia Equipment: Principles and Applications. St Louis, MO: Mosby; 1993:521–533.Google Scholar
  2. 2.
    Committee on Drugs. American Academy of Pediatrics. Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: addendum. Pediatrics. 2002;110:836–838.CrossRefGoogle Scholar
  3. 3.
    American Society of Anesthesiologists: Standards for Basic Anesthetic Monitoring, October 25, 2005.Google Scholar
  4. 4.
    Report of the Advisory Committee on the Biological Effects of Ionizing Radiations: The effects on populations of exposure to low levels of ionizing radiation. Division of Medical Sciences, National Academy of Sciences, National Research Council, BEIR III 1980, Washington, D.C.: National Academy Press; 1980.Google Scholar
  5. 5.
    Robertson RL, Robson CD, Zurakowski D, Antiles S, Strauss K, Mulkern RV. CT versus MR in neonatal brain imaging at term. Pediatr Radiol. 2003;33:442–449.CrossRefPubMedGoogle Scholar
  6. 6.
    Upton AC. National Council on Radiation Protection and Measurements Scientific Committee 1–6. The state of the art in the 1990s: NCRP Report No. 136 on the scientific bases for linearity in the dose-response relationship for ionizing radiation. Health Phys. 2003;85:15–22.CrossRefPubMedGoogle Scholar
  7. 7.
    Modan B, Keinan L, Blumstein T, Sadetzki S. Cancer following cardiac catheterization in childhood. Int J Epidemiol. 2000;29:424–428.CrossRefPubMedGoogle Scholar
  8. 8.
    Mason KP, Zgleszewski SE, Holzman RS. Anesthesia and sedation for sedation for procedures outside the operating room. In: Motoyama EK, Davis PJ, eds. Smith’s Anesthesia for Infants and Children. 7th ed. Philadelphia, PA: Mosby Elsevier; 2006: 839–855.Google Scholar
  9. 9.
    Cohan RH, Dunnick NR, Bashore TM. Treatment of reactions to radiographic contrast material. AJR Am J Roentgenol. 1988;151:263–270.PubMedGoogle Scholar
  10. 10.
    Martin LD, Pasternak LR, Pudimat MA. Total intravenous anesthesia with propofol in pediatric patients outside the operating room. Anesth Analg. 1992;74:609–612.PubMedGoogle Scholar
  11. 11.
    Fisher DM, Robinson S, Brett CM. Comparison of enflurance, halothane, and isoflurane for diagnostic and therapeutic procedures in children with malignancies. Anesthesiology. 1985;63:647–650.CrossRefPubMedGoogle Scholar
  12. 12.
    Menon DK, Peden CJ, Hall AS, et al. Magnetic resonance for the anaesthetist. Part 1: physical principles, application, safety aspects. Anaesthesia. 1992;47:240–255.CrossRefPubMedGoogle Scholar
  13. 13.
    Tobin JR, Spurrier EA, Wetzel RC. Anaesthesia for critically ill children during magnetic resonance imaging. Br J Anaesth. 1992;69:482–486.CrossRefPubMedGoogle Scholar
  14. 14.
    Peden CJ, Menon DK, Hall AS, et al. Magnetic resonance for the anaesthetist. Part II: anaesthesia and monitoring in MR units. Anaesthesia. 1992;47:508–517.CrossRefPubMedGoogle Scholar
  15. 15.
    Gold JP, Pulsinelli W, Winchester P, et al. Safety of metallic surgical clips in patients undergoing high-field-strength magnetic resonance imaging. Ann Thorac Surg. 1989; 48:643–645.PubMedCrossRefGoogle Scholar
  16. 16.
    Erlebacher JA, Cahill PT, Pannizzo F, et al. Effect of magnetic resonance imaging on DDD pacemakers. Am J Cardiol. 1986;57:437–440.CrossRefPubMedGoogle Scholar
  17. 17.
    Shellock FG, Curtis JS. MR imaging and biomedical implants, materials, and devices: an updated review. Radiology. 1991;180:541–550.PubMedGoogle Scholar
  18. 18.
    Patteson SK, Chesney JT. Anesthetic management for magnetic resonance imaging: problems and solutions. Anesth Analg. 1992;74:121–128.CrossRefPubMedGoogle Scholar
  19. 19.
    Shellock FG. Monitoring during MRI: an evaluation of the effect of high-field MRI on various patient monitors. Med Electron. 1986;17:93–97.PubMedGoogle Scholar
  20. 20.
    Dimick RN, Hedlund LW, Herfkens RJ, et al. Optimizing electrocardiographic electrode placement for cardiac-rated magnetic resonance imaging. Invest Radiol. 1987; 22:17–22.CrossRefPubMedGoogle Scholar
  21. 21.
    Shellock FG. Monitoring sedated pediatric patients during MR imaging. Radiology. 1990;177:586–587.PubMedGoogle Scholar
  22. 22.
    Cote CJ. Anesthesia outside the operating room. In: Cote CJ, Ryan JF, Todres ID, Goudsouzian NG, eds. A Practice of Anesthesia for Infants and Children. 3rd ed. Philadelphia, PA: W.B. Saunders; 2001:571–583.Google Scholar
  23. 23.
    Frankville DD, Spear RM, Dyck JB. The dose of propofol required to prevent children from moving during magnetic resonance imaging. Anesthesiology. 1993;79:953–958.CrossRefPubMedGoogle Scholar
  24. 24.
    Shellock FG. Biological effects of MRI: a clean safety record so far. Diagnostic Imaging. 1987;9:96–101.Google Scholar
  25. 25.
    Hammer GB, Hall SC, Davis PJ. Anesthesia for general abdominal, thoracic, urologic and bariatric surgery in pediatric patients. In: Motoyama EK, Davis PJ, eds. Smith’s Anesthesia for Infants and Children. 7th ed. Philadelphia: Mosby Elsevier; 2006: 685–722.Google Scholar
  26. 26.
    Lebovic S, Reich DL, Steinberg LG, et al. Comparison of propofol versus ketamine for anesthesia in pediatric patients undergoing cardiac catheterization. Anesth Analg. 1992;74:490–494.CrossRefPubMedGoogle Scholar
  27. 27.
    Vida VL, Bottio T, Milanesi O, et al. Critical aortic stenosis in early infancy: surgical treatment for residual lesions after balloon dilation. Ann Thorac Surg. 2005;79: 47–51.CrossRefPubMedGoogle Scholar
  28. 28.
    Koenig P, Cao QL, Heitschmidt M, Waight DJ, Hijazi ZM. Role of intracardiac echocardiographic guidance in transcatheter closure of atrial septal defects and patent foramen ovale using the Amplatzer device. J Interv Cardiol. 2003;16:51–62.CrossRefPubMedGoogle Scholar
  29. 29.
    Wagner KJ, Mollenberg O, Rentrop M, Werner C, Kochs EF. Guide to anaesthetic selection for electroconvulsive therapy. CNS Drugs. 2005;19:745–758.CrossRefPubMedGoogle Scholar
  30. 30.
    Patkar AA, Hill KP, Weinstein SP, Schwartz SL. ECT in the presence of brain tumor and increased intracranial pressure: evaluation and reduction of risk. J ECT. 2000; 16:189–197.CrossRefPubMedGoogle Scholar
  31. 31.
    van den Broek WW, Leentjens AF, Mulder PG, Kusuma A, Bruijn JA. Low-dose esmolol bolus reduces seizure duration during electroconvulsive therapy: a doubleblind, placebo-controlled study. Br J Anaesth. 1999;83:271–274.PubMedGoogle Scholar
  32. 32.
    Mitchell P, Torda T, Hickie I, Burke C. Propofol as an anaesthetic agent for ECT: effect on outcome and length of course. Aust NZ J Psych. 1991;25:2255–2261.Google Scholar
  33. 33.
    Simpson KH, Snaith RP. The use of propofol for anaesthesia during ECT. Br J Psychiatry. 1989;154:721–722.CrossRefPubMedGoogle Scholar
  34. 34.
    Boey WK, Lai FO. Comparison of propofol and thiopentone as anesthetic agents for electroconvulsive therapy. Anaesthesia. 1990;45:623–628.CrossRefPubMedGoogle Scholar
  35. 35.
    Hodgson RE, Dawson P, Hold AR, Rout CC, Zuma K. Anaesthesia for electroconvulsive therapy: a comparison of sevoflurane with propofol. Anaesth Intensive Care. 2004;32:241–245.PubMedGoogle Scholar
  36. 36.
    Singh A, Shah G, Young J, Sheridan M, Haas G, Upadhyay J. Ureteral access sheath for the management of pediatric renal and ureteral stones: a single center experience. J Urol. 2006;175(3 Pt 1):1080–1082.CrossRefPubMedGoogle Scholar
  37. 37.
    Liou LS, Streem SB. Long-term renal functional effects of shock wave lithotripsy, percutaneous nephrolithotomy and combination therapy: a comparative study of patients with solitary kidney. J Urol. 2001;166:36.CrossRefPubMedGoogle Scholar
  38. 38.
    Aldridge RD, Aldridge RC, Aldridge LM. Anesthesia for pediatric lithotripsy. Paediatr Anaesth. 2006;16:236–241.CrossRefPubMedGoogle Scholar
  39. 39.
    Roth RA, Beckman F. Complications of extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy. Urol Clin North Am. 1988;15:155–166.PubMedGoogle Scholar
  40. 40.
    Pettersson B, Tiselius HG, Andersson A, Eriksson I. Evaluation of extracorporeal shock wave lithotripsy without anesthesia using a Dornier HM3 lithotriptor without technical modifications. J Urol. 1989;142:1189–1192.PubMedGoogle Scholar
  41. 41.
    Cicek M, Koroglu A, Demirbilek S, Teksan H, Ersoy MO. Comparison of propofolalfentanil and propofol-remifentanil anaesthesia in percutaneous nephrolithotripsy. Eur J Anaesthesiol. 2005;22:683–688.CrossRefPubMedGoogle Scholar
  42. 42.
    Aldridge RD, Aldridge RC, Aldridge LM. Anesthesia for pediatric lithotripsy. Paediatr Anaesth. 2006;16:236–241.CrossRefPubMedGoogle Scholar
  43. 43.
    Zeitlin GL, Roth R. Effects of three anesthetic techniques on the success of extracorporeal shock wave lithotripsy in nephrolithiasis. Anesthesiology. 1988;68:272–276.PubMedGoogle Scholar
  44. 44.
    Malhotra V, Long CW, Meister MJU. Intercostal blocks with local infiltration anesthesia for extracorporeal shock wave lithotripsy. Anesth Analg. 1987;66:85–88.CrossRefPubMedGoogle Scholar
  45. 45.
    Tritrakarn T, Lertakyamanee J, Koompong P, et al. Both EMLA and placebo cream reduced pain during extracorporeal piezoelectric shock wave lithotripsy with the Piezolith 2300. Anesthesiology. 2000;92:1049–1054.CrossRefPubMedGoogle Scholar
  46. 46.
    Basar H, Yilmaz E, Ozcan S, et al. Four analgesic techniques for shockwave lithotripsy: eutectic mixture local anesthetic is a good alternative. J Endourol. 2003; 17:3–6.CrossRefPubMedGoogle Scholar
  47. 47.
    Fisher DM: Sedation of pediatric patients: an anesthesiologist’s perspective. Radiology. 1990;175:613–615.PubMedGoogle Scholar
  48. 48.
    Cote CJ. Sedation for the pediatric patient: a review. Ped Clin North Am. 1994; 41:31–58.Google Scholar
  49. 49.
    American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by nonanesthesiologists. Anesthesiology. 2002;96:1004–1017.CrossRefGoogle Scholar
  50. 50.
    Hoffman GM, Nowakowski R, Troshynski TJ, Berens RJ, Weisman SJ. Risk reduction in pediatric procedural sedation by application of an American Academy of Pediatrics/American Society of Anesthesiologists process model. Pediatrics. 2002; 109:236–243.CrossRefPubMedGoogle Scholar
  51. 51.
    American Society of Anesthesiologists’ Guidelines for Nonoperating Room Anesthetizing Locations. American Society of Anesthesiologists; October 15, 2003.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Steven C. Hall
    • 1
  1. 1.Children’s Memorial Hospital, Feinberg School of MedicineNorthwestern UniversityChicagoUSA

Personalised recommendations