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Treebeard would be very upset.

October 29, 2012

So I did anesthesia for some cataract cases last week.  As these things go, cataratcts are super simple for the anesthesiologist.  Most of the time I just give a small amount of something called Remifentanil.  This is an ultra-short-acting narcotic that puts you to sleep for about 1 minute.  During this time the eye doctor does what we call a retrobulbar block, meaning that he uses a needle to put local anesthetic right behind your eye and numb it all up.  Then you wake up, having not remembered much about that injection, and you lie back and relax and I do the same.  

Given that most caratarct patients are elderly, the tendency has always been to over-test people before cataract surgery.   Sometimes doctors will require full labs, ekgs, chest xrays, etc.  Please believe me, THIS IS NOT NECESSARY.   Recently a young man came for surgery on his eye.  He was 25 years old and had implantable contact lenses (I was not aware such a thing was possible).  He had, like an idiot, gone out and played ice hockey without a helmet, got struck in the eye, and dislodged his contact.  Took 5 minutes to fix.  That poor guy was in the hospital for 2 hours and had 37 pieces of paper in his chart for that surgery.  THIRTY SEVEN PAGES.  You have the booking form, the insurance form, the 5 page nursing assessment, the history and physical from the primary doc, the report of the opthalmologist exam, the anesthesia record, the 5 page intra-operative nursing record, post op orders, post-op pacu note, discharge instructions, etc. etc. etc.

Mr.’s Obama and Romney:  you wanna save some health care dollars?  Look here.

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From → Healthcare

2 Comments
  1. Not to even mention all the people-hours occupied in generating that paper instead of taking care of patients!

  2. Cale permalink

    A wise anesthesia queen once told me: “Having cataract surgery is about as stimulating as getting your hair cut.” These words guide *many* of the decisions I make about pre-op testing.

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