Obstructive sleep apnea, higher ASA-PS scores and greater doses of intraoperative opioids were associated with naloxone administration during Phase I recovery. Patients administered naloxone had increased adverse events after discharge from the recovery room and may benefit from a higher level of postoperative care.

Smokers with fibromyalgia reported smoking helped to cope with fibromyalgia pain but generally did not directly ameliorate fibromyalgia physical symptoms.

Background The nature of pages associated with periprocedural emergency events in ambulatory centers has never being examined. Our institution has a proprietary anesthesiology paging system with hierarchal paging capabilities (emergency versus routine) and maintains a log of all events. Here we describe emergency pages in our ambulatory surgery centers. Methods We identified all emergency page activations between June 1, 2008, and December 31, 2012 in our ambulatory surgical centers. Electronic medical records were reviewed for rates and characteristics of pages such as primary cause, interventions performed, and outcomes. Results During the study time frame, 120,618 procedures were performed and 93 emergency pages were recorded (7.7 per 10,000 cases, 95% CI, 6.2 – 9.4), of which 51 originated in the procedure room and 42 outside the procedure room (16 before and 26 after the procedure). Among those 14/93 were associated with serious events (1.2 per 10,000 cases). Among emergency pages for bradyarrhythmias (N=35, 2.9 per 10,000 cases), 15 occurred during intravenous line placement in the preprocedural area, 11 during postprocedural recovery, and 9 during the procedure. Bradyarrhythmias accounted for 60.4% of pages outside the procedural room. In contrast, respiratory and airway events (N=31, 2.6 per 10,000 cases) typically occurred in the procedural room (28 vs. 9, P = 0.0006). Only one patient sustained permanent injury, myocardial infarction and death 4 months later. Another patient died after 8 days from unrelated causes. Conclusion The rates of emergency page activations, especially those representing critical events, in our surgical ambulatory center are rare. Many emergency pages originated outside the procedural room, therefore providers within these areas should be trained to promptly recognize and treat these events.