Anesthesiology

Anesthesiology

Resolute Perioperative Services LLC has been formed in order to provide the newest modalities in perioperative care to our patients. 

‚ÄĮOur scope of practice is 3-fold:¬†

1- Preoperative Patient Evaluation and Management‚ÄĮ¬†

Upon referral, we contact our scheduled surgical patients for an evaluation and management either in person or via telemedicine and review their past medical history and medications.   

If indicated,‚ÄĮa¬†sub-specialty medical consult¬†is¬†obtained¬†and we¬†recommend¬†an appropriate and targeted pre-procedural laboratory testing.‚ÄĮ¬†

If directed, we will recommend a pre-emptive analgesia regimen toward postoperative pain management incorporating non-narcotic based medications in order to better manage the patient’s post-op recovery and reduce narcotics prescriptions. 

We recommend an adequate and timely preoperative food and liquid intake in order to prevent a catabolic postoperative state and improve patient’s surgical experience and wound healing process.  We identify any risk the patients may have in their cardiac and pulmonary status and take appropriate measures to reduce a cardiac event and pulmonary complications.   

We review a patient’s allergy status and take the appropriate steps to administer the most appropriate prophylaxis antibiotics prior to the surgical incision.   

We identify any risk the patients may have for postoperative nausea and vomiting and use preventive modalities to reduce the incidence of PONV.   

We specialize in preoperative anemia correction.  By infusing our patients with intravenous iron, vitamins, and erythropoietin as necessary, we will correct our patient’s low red blood cell count and reduce the risks of perioperative blood transfusion.   

2- Intraoperative Anesthesia Management 

We apply the latest techniques of airway management, as well as providing general, major neuroaxial, TIVA (total intravenous anesthesia), and MAC (monitored anesthesia care) sedation to our patients.   

We are mindful of the amount of fluid infused during the surgical procedure  and apply great care to our patient’s intraoperative fluid management.  These techniques allow the patient to recover from anesthesia, permit a mental status assessment to take place, and patients are verbal much sooner than with conventional general anesthesia.  We use the concept of PPV (pulse pressure variation) to administer the adequate amount of intravenous fluid to our patients.  The concept of Goal Directed Fluid Therapy enables the patient to go through their surgical procedures with adequate intravenous infusion to avoid swelling and edema in order to facilitate wound healing and diuresis.   

By applying techniques of intraoperative acute normovolemic hemodilution (ANH), we help reduce the surgical blood loss and postoperative blood transfusion.   

3- Postoperative Management 

We continue with patient care in the PACU (post-anesthesia care unit), and our main goal is to limit the use of narcotics for postoperative pain control.  

We advocate regional blocks for upper and lower extremities surgeries and provide tap blocks for abdominal surgeries and paravertebral, erector spinae, and PECs blocks for surgeries on the chest, breast, and thoracotomies.   

We manage the patients post course in PACU until discharge with a follow up. 

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