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Outpatient Surgery E-Weekly

Contact Congress Over Drug Shortage Issues

A Kentucky congressman is urging surgical facilities to contact their members of Congress and request that they sign his letter demanding changes to...

N.J. Posts ASC Inspection Reports Online

State and federal inspection reports of New Jersey's ASCs are now available online, giving patients an opportunity to make more informed choices abo...

Are Opioids Necessary?

While it's not always practical, or even possible, to eliminate opioids from your post-op pain management regiment, reducing their use in favor of n...

Archive > June, 2008 Vol. IX, No. 6

Letters & E-mails

Anesthesia Clearance

So, Who's Responsible for Clearing Patients for Anesthesia?
Re: "A Case of Inadequate Informed Consent" (April, page 25). It should have been clear to the anesthesiologist that this patient with significant cardiac and pulmonary morbidity and an undefined degree of obesity wasn't a candidate for interscalene block. Not only did the block have to be converted to general anesthesia, but it also complicated the course of general anesthesia, as this patient would certainly need post-operative ventilator support because of the successful interscalene block. The shortness of breath and restlessness is a symptom of phrenic nerve paralysis, which is typical in a successful interscalene block. Of course, this patient needed rescue as he had longstanding COPD, coronary artery disease and heart failure with cardiomyopathy. The anesthesiologist should not have been left off the hook on this one. Poor choice!

Michael Wolf, CRNA
Renaissance Surgery Center
Oshkosh, Wis.
michael.wolf@chnwi.org

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