Ambulatory Surgery Protocol Reduces Post-Op Returns

There was reduced postoperative pain when preoperative carbohydrate treatment was completed, with MAC, and when multimodal analgesia was used. There were decreased preventable returns to the emergency department or urgent care when MAC was used, and there were more returns for constipation, but fewer returns for pain, following preoperative carbohydrate treatment. Local anesthesia was associated with fewer returns for constipation. The study was published on January 9, 2018, in World Journal of Surgery.

“When people return to the emergency department or urgent care for pain control, urinary retention, constipation, or nausea and vomiting after same day inguinal hernia repair, we feel that those returns could have been prevented if our perioperative care routines had addressed them up front,” said study co-author Steven Crain, MD, of KPSC Woodland Hills. “With these standardized pathways, we’re able to improve the quality of care for the patient and the efficiency of health care delivery for the organization.”

MAC, also known as twilight sleep, is a planned procedure during which the patient undergoes local anesthesia together with sedation and analgesia in order to provide safe conscious sedation, control of patient anxiety, and pain control. MAC can be obtained with the association of fast half-life drugs or via an infusion regimen. Patient consciousness evaluation is also of extreme importance during the surgical procedure performed with MAC.

Related Links:
Kaiser Permanente Southern California