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JOIN THE DISCUSSION - TOP 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". Your question, reply or comment will be published in the next available issue of SAMBA TALKS. Include your name (or initials), email address, 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 publication. SAMBA Talks will include all discussion questions we receive considered of interest to the membership at large. We will endeavor to publish a response to at least one of these questions. The response will be from experts in the field, and from those willing to express a view on a particular topic, backed by experience and/or published evidence. Where email addresses are published, those individuals have indicated their interest in discussing the published questions. 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.
What are the current recommendations for perioperative beta-blocker usage? Should all centers have a protocol in place or is that not yet the standard of care? -- From: Anonymous Reply The beta blocker story continues to evolve. Preliminary reports on the results of the POISE trial indicate that the small benefit in reduction of non-fatal cardiac events by beta blockers is offset by an increase in strokes in the beta blocker group. So most likely the only class I indication for perioperative beta blockade is to continue pre existing beta blocker therapy. I believe that a policy should be in place to show regulatory personnel that you have considered the available data and made a rational decision about where these drugs fit in your perioperative armamentarium. That being said there is probably almost no patients who should need perioperative beta blockade for CV protection for ambulatory procedures. -- From: Robert Helfand, M.D., Cleveland, OH
I am looking for the general consensus on whether patients that have a history of true latex allergy, not just sensitivity, are acceptable outpatient surgical candidates or should they be only done as inpatients? Thank you in advance. -- From: Michael Koumas, Columbus, OH (mkoumas@hotmail.com)
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