title: Special anesthetic concerns in mentally handicapped institutionalized patients undergoing gynecological procedures in an outpatient setting.
abstract: OBJECTIVE
  To evaluate the anesthesia issues involved in caring for mentally handicapped outpatients.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University-affiliated outpatient ambulatory center.
  
  
  METHODS
  Twenty adult patients scheduled for gynecological procedures.
  
  
  METHODS
  None.
  
  
  METHODS
  Data collection sheet was used to record patients' age, ASA status, procedure, premedication, intravenous placement, degree of agitation, airway control, induction (method and drugs), intraoperative anesthesia care, postoperative medications, total time in hospital, postanesthesia care unit time and disposition.
  
  
  RESULTS
  Agitation was present in 100% of the patients. A significant number of these patients were ASA III, needing oral or intramuscular sedation (35%) or mask induction prior to placement of an intravenous line. Severely agitated patients had the longest stays in the postanesthesia care unit (PACU).
  
  
  CONCLUSIONS
  Agitation was the main reason why 90% of the patients required intubation for relatively minor procedures. Agitation was the main factor leading to prolonged recovery room time.
authors.affiliation: Department of Anesthesiology and Obstetrics, Yale University School of Medicine, New Haven CT 06520-8051, USA. nalini.vadivelu@yale.edu
authors.forename: Nalini
authors.initials: N
authors.lastname: Vadivelu
authors.forename: Peter
authors.initials: P
authors.lastname: Harkness
authors.forename: Susan
authors.initials: S
authors.lastname: Richman
authors.forename: Kirk H
authors.initials: KH
authors.lastname: Shelley
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General / Q000592:standards*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007326:Institutionalization; D008875:Middle Aged; D019989:Persons with Intellectual Disabilities / Q000523:psychology*; D011595:Psychomotor Agitation / Q000145:classification; D012189:Retrospective Studies