Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast Episode 308: Keywords Part 30: Ambulatory Anesthesia
May 18, 2025
Dr. Tim Kajstura, an experienced anesthesiologist, returns to discuss the intricacies of ambulatory anesthesia. He emphasizes the critical aspects of patient selection, addressing factors like obesity and sleep apnea. The importance of optimizing anesthetic management for quicker recoveries, as well as effective strategies to minimize postoperative nausea and vomiting, are thoroughly explored. Additionally, Dr. Kajstura shares insights on discharge criteria and the safe practices necessary for office-based procedures, blending expertise with engaging anecdotes.
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Key Principles of Ambulatory Surgery
- Ambulatory surgery should focus on elective cases with low complication rates and fast recovery.
- Patient selection must consider comorbidities like obesity and sleep apnea but isn't strictly limited by ASA status.
OSA Key Admission Risk Factor
- Obstructive sleep apnea is the biggest risk factor for unplanned hospital admission after ambulatory anesthesia.
- Obesity and hypertension carry less risk but remain important considerations.
Applying ASA Classification Correctly
- ASA physical status classification helps stratify patient risk in ambulatory settings.
- Morbid obesity with comorbidities qualifies as ASA 3, while recent MI patients within 3 months are higher risk.