SAMBA Talks eNewsletter - August, 2006

Volume 6, Issue 3

S A M B A T A L K S - PAGE 2

August, 2006

JOIN THE DISCUSSION - TOP

Need advice about a problem case in ambulatory anesthesia? Want suggestions about a difficult situation in your ambulatory surgery center? Have a reply to questions others have raised about ambulatory anesthesia issues?

If you answered "yes" to any of these questions, or would like to share with other professionals a comment or opinion on a topic related to ambulatory anesthesia then please "Join the Discussion" here.

To enter the Discussion with a question, reply, or other comment, please contact us. Your submission will be published in this section of the next available issue of SAMBA TALKS. Include your name (or initials), city, and state, if you would like these published. Please note that because of the high volume of questions we receive, there is often a delay of 1 to 2 months before the questions can be published.

Questions and responses from previous months are now available at the eNewsletter Discussion Archive. If you have any comments regarding the previous questions, please submit them to SAMBA Discussion, and they will be published here next month.

Please note: The information presented in the replies below does not represent SAMBA policy. The replies are solely the opinions of the individuals who wrote them.

?? - LAST MONTH'S QUESTION WITH REPLY - ?? - TOP

Guidelines for Body Mass Index and Gastroscopy/Colonoscopy

For an EGD (gastroscopy) or colonoscopy what is considered a safe or unsafe BMI for patients that have no other health concerns, and also for patients that have other factors to consider? We are an ambulatory surgical center constantly being faced with weight factors. I am trying to set some sort of guideline for the office to follow when scheduling these procedures. I would appreciate any input available.

-- Susan, Ft Myers, FL.

Answer:

I think there is no arbitrary BMI that can be selected for allowing EGDs or colonoscopies at an ambulatory surgery center. There are several factors to consider. First, what is the maximum allowable weight on the operating room tables or the carts in the GI suite? Second, what is the allowable BMI for any surgical procedure at your ambulatory surgical center? This procedure has to be treated like any other anesthetic at the ambulatory surgical center using the same rules. A MAC anesthetic has the same potential risks whether it is performed in an OR or in a GI suite.

-- David S. Rapkin, M.D., Richmond Heights, OH

?? -- THIS MONTH'S QUESTION -- ?? - TOP

Duloxetine(Cymbalta) and Drug Interactions

Part of the action of Duloxitine (Cymbalta) is the inhibition of norepinephrine reuptake. Because it is relatively new to the market, there has been some concern regarding this effect, but little opportunity for large-scale study of its potential interaction with anesthetics. Is it reasonable to admit patients on this drug for surgery in an ASC or office setting where vasoactive drugs and monitoring are limited?

-- Paul Berghuis, M.D., Mount Vernon, WA

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