General anesthesia is very commonly used to induce unconsciousness in patients undergoing surgery. Each year millions of people in the United States are required to receive anesthesia, and there is no single right amount for every patient. Factors such as weight, age, gender, illness, and medications all play a role in determining just how much anesthesia each person needs. A patient’s heart rate and rhythm, breathing rate, blood pressure, and oxygen and carbon dioxide levels are also monitored so the amount of anesthesia can be adjusted as needed. A recent study from the University of Cambridge, published in PLOS Computational Biology, may have identified a better way to calculate the amount of anesthesia one may need. A group of 20 volunteers were involved in this study to discover how brainwaves can identify patient anesthesia needs. The Brain Signals and Anesthesia As different areas of the brain communicate with each other they give off signals that can indicate a person’s level of consciousness. In the study, researchers gave a steadily increasing dosage of propofol to the group of healthy volunteers (9 male, 11 female). Their brain activity was monitored using an electroencephalogram (EEG). While receiving the propofol, the individuals were asking to perform a simple task where they would hit one button after hearing a “ping” and a different button after hearing a “pong”. All of the people involved in this study had the same limited amount of propofol and once that limit was hit some were unconscious while others were still awake and able to continue performing the task. Researchers studied EEG results and found a very clear difference between that brain activity of those who were affected by that amount of anesthetic and those who were still able to perform the task. EEG readings showed that volunteers with more alpha wave activity prior to receiving the anesthesia required more propofol to put them under. Researchers said “These findings could lead to more accurate drug titration and brain state monitoring during anesthesia,”. Dr Tristan Bekinschtein, senior author from the Department of Psychology, adds: “EEG machines are commonplace in hospitals and relatively inexpensive. With some engineering and further testing, we expect they could be adapted to help doctors optimise the amount of drug an individual needs to receive to become unconscious without increasing their risk of complications.” Although this is a relatively new study, many agree that with more testing and research, monitoring brainwave activity prior to administering anesthesia may be a useful, non-invasive way of measuring the dosage needed for each unique patient.
Before the development of Ambulatory Surgery Centers, or ASCs, it was not uncommon for patients to wait several weeks or months to get an appointment for surgery, or to spend days or weeks in the hospital recovering. With hopes to change this by providing affordable and accessible outpatient surgery alternatives, two doctors, named Wallace Reed and John Ford, came up with the idea for freestanding ambulatory surgery centers. In 1970, this idea became a reality when they opened their first Ambulatory Surgery Center called, Surgicenter, in Phoenix, Arizona.
The effects of the use of anesthesia on infants and young children have been a concern for doctors and parents for many years. Each year, millions of patients are exposed to anesthesia during surgery, and about a half a million of those patients are children under the age of three. In the past, studies have been done on young monkeys and other animals that showed anesthetics may kill brain cells, affect memory, and cause behavioral problems. However, since these were animals and not children, these studies offered no definitive results.
As we approach the 170th anniversary of the first successful use of a form of anesthesia in a public procedure, it makes sense to think of how anesthesia has changed the world of medicine. Before surgical anesthesia services, surgery was extremely uncommon and only performed when absolutely necessary. Patients and physicians avoided operations due to the unbearable amount of pain that would come with the procedure.
It is no surprise that at a time where technology is rapidly changing and advancing, machines are sometimes being used to replace humans to perform certain jobs. Some believe that machines can perform tasks and make decisions more efficiently than humans. The world of healthcare and anesthesia service is not immune to these types of practices.
The last of this four part series striking down the myths behind the use of an anesthesia management solutions focuses on time. Many facilities are of the mindset that by having their own, in-house anesthesia team provides them with the most flexible option as it relates to availability and time. However, regional anesthesia management solutions actually have the ability to offer improved flexibility as it relates to anesthesia services.
In today’s world, every company is being asked to take on more responsibilities with the same or, unfortunately, sometimes even less resources. Finding cost efficiencies does not always mean going without something; it sometimes means absorbing the workload in another area. The world of healthcare, and anesthesia, is not immune to this practice.
“That’s like comparing apples to oranges.” How many times have you heard or even used this expression? In medicine, no two patients, no two hospitals, not two…well, anything is the same. So why do so many healthcare facilities still use the excuse that there isn’t any difference between anesthesia management solutions organizations?
Opportunities arise daily where facilities can improve the management of anesthesia care. The passage of the Affordable Care Act may appear to have resulted in “affordable care” for everyone, but for hospitals, surgery facilities or healthcare practices, it has created more challenges than many believed it would. The game has changed from clear standards to blurred lines consisting of regulatory issues that make the possibility of being compliant more and more difficult. When this happens, facilities look towards third party solutions to help make sense of it all.
There is a difference between providing anesthesia services and being an anesthesia management company. As more and more facilities are being penalized for not taking proper precautions to prevent patient infections and other complications considered by the government to be unavoidable, hospitals are at risk for losing millions of dollars in Medicare reimbursements. It is imperative for hospital executives to focus on ways to maximize revenue while continuing to improve quality of care in the ever changing and challenging world of healthcare. Anesthesia services make up one of the biggest opportunities where a review can prove to have an untapped source of additional financial benefits for these facilities.
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