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July 11, 1997     Cape Gazette
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July 11, 1997

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CAPE GAZETTE, Friday, July 11 -July 17, 1997.41 Advancements inanesthesiolgy help patients go home faster Dorothy Gale from Kansas in the Wizard of Oz wasn't the first, Or the last, to discover that there's no place like home. The comfort of familiar surroundings is even more important when someone isn't feeling their best. Doctors understand that importance, which is why healthcare profes- sionals endorse the trend toward shorter hospital stays. Of course, no doctor woult!, send their patients home before they were safely on the road to recovery. That "road" is made eas- ier and shorter for surgery patients by'the many innovations in healthcare which have made sur- gical procedures less invasive and most medications less pervasive. Beebe Medical Center anesthe- siologists credit getting patients back home quickly and safely to improvements in surgical tech- niques and post-operative pain management. John DiBonaventure M.D, Stephen Fanto M.D., Anthony Masone M.D. and Robert Wilt- shire M.D., make up the anesthe- Siology staff at Beebe Medical Center. Masone explained that anesthe- siologists are responsible for mon- itoring a patient during surgery and until that patient's condition has stabilized and he or she is ready to leave the recovery room. "Number one, I keep the patient safe," he said, "and I keep the patient comfortable. The patient may be totally unconscious or may receive a comforting sedative and a regional block for the proce- dure. At Beebe, anesthesiologists meet each patient in a pre-opera- tire interview. It is the patient's opportunity to ask questions, and the doctor's opportunity to make an assessment of the patient. Both questions and assessments help the surgeon/anesthesiologist/patient team decide which category and type of anesthesia is best for the individual situation. "It's not just one from column A and one from column B," said Masone. The first consideration is whether the surgical procedure requires a general, regional or local anesthesia. In general anes- thesia, the patient is totally uncon- scious; the brain receives and remembers no input; the body is paralyzed; the nerves and muscles are insensitive to all sensation; and a ventilator must breathe for the patient. Under a regional anesthetic, the patient may be aware of activity and even talk with operating room staff, but medications reduce anxi- ety and large portions of the body are rendered insensitive to pain. A local anesthetic numbs a very small area while the patient is ful- ly awake. Once it's been determined just how "awake" a latient needs (or wants) to be for a surgical proce- dure, the specific type of medica tion can be decided. Some general anesthesia is still administered through inhalation, just like in old movies where the patient is told to breathe deeply through a mask. General anesthesia is also deliv- ered intravenously, just as it has been for many years. One form of regional anesthesia many people are familiar with is the term "spinal block." "Anyone who had a spinal block some 20 years ago starts shaking their head 'no' when I mention it," said Fanto. "But when I explain there fiave been improvements and all the benefits, they'll agree to it. Then, later, they'll say how much better they feel." One innovation appreciated by all patients is the development of superfine needles, used to per- form spinal blocks. Similar to a spinal anesthetic is the epidural technique in which anesthesia is delivered through a tiny catheter inserted between the vertebrae. It is left in place to feed a con- tinual supply of medication during the post-operative period. The epidural catheter can relieve pain for several days after some surgi- cal procedures, and is easily removed at the patient's bedside. "The drugs 20 years ago were muchdifferent than today," said Masone. "Today, they are more selective, faster acting and metab- olized very quickly." "It used to be the patient would sleep all day after surgery, but Continued on page 42 Beebe Medical Center anesthesiologists credit getting patients back home quickly and safely to improvements in surgical techniques and post-operative pain management. . 00l"Second Time Aroun '"", " ,, New & Used Clothing for Ladies and Gents  " WANTED THIS Ladies Sequin ,," WEEK and Fancy Dresses , ! Hours Tuesday - Friday 11 - 4 Saturday 11 - 2 , " Henlopen Junction, Rehoboth Avenue Extended 227-3550 4 4tl 4* ANTIOXIDANT THERAPY Antioxidants - The Shield of Lfe Antioxidants are special compounds which pre- vent damage from free radicals. They are nutrients which specifically target these free rttdicals and pro- vide them with a single electron which renders them harmless. 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