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Anesthetic Techniques 

Anesthetic Techniques
Anesthetic Techniques

Laurence M. Hausman

and Meg A. Rosenblatt

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date: 12 August 2020

Anesthetic techniques for procedures performed outside the traditional operating room (OOOR) are as varied as the surgeries themselves and wholly dependent upon the equipment available at each specific location as well as any patient comorbidities that may exist. General anesthesia (GA) may be delivered with or without an anesthesia machine, monitored anesthesia care (MAC) with or without infusion pumps, and regional anesthesia (RA) with or without a nerve stimulator (NS) or ultrasound (US). Whatever technique is chosen, safety considerations are paramount and perioperative monitoring must always be consistent with American Society of Anesthesiologists (ASA) guidelines (see Appendix for a list of useful ASA documents). OOOR procedures are widely varied and include elective office-based anesthetics and emergency room ones, endoscopic retrograde cholangiopancreatographies (ERCPs) in the gastroenterology suite, and emergency interventions in the invasive radiology department. Most of these locations have limited postanesthesia care unit (PACU) capabilities, so both rapid return to baseline functioning and the ability to discharge a comfortable patient are important goals with rare exceptions that will be discussed. This chapter will focus on the many anesthetic options available to the OOOR anesthesiology practitioner.

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