Patient blood management and patient safety
Purpose of review The particular fields within patient blood management (PBM) and patient safety reviewed here include novel insights into bleeding therapy, autologous cell salvage, and perioperative anemia therapy. Recent finding World Health Organization has published that implementation of PBM is important but has not yet been performed in all hospitals. Two antibodies that mimic the function of FVIII, Emicizumab, and Mim8 have been developed. Tranexamic acid (TXA) has been investigated further in patients with hip surgery and shows reduction of bleeding. Thrombocytopenia in patients undergoing cardiac surger...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Daniel Arna Source Type: research

Elimination of punitive outcomes and criminalization of medical errors
Purpose of review The penalization of error in the health field continues to be one of the main barriers in the notification, analysis and proposals for measures to improve adverse events. Strategies should be established in order to develop a nonpunitive culture with the sole purpose of learning from mistakes and improving patient safety. Recent findings Strategies are established for the development of a nonpunitive culture, such as promoting confidentiality and data protection in the notification and analysis of adverse events. Summary Despite education, improvements in quality and safety in healthcare...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Daniel Arna Source Type: research

Checklists and cognitive aids: underutilized and under-researched tools to promote patient safety and optimize clinician performance
Purpose of review Checklists and other cognitive aids serve multiple purposes in the peri-operative setting and have become nearly ubiquitous in healthcare. This review lays out the evidence for their use, shortcomings and pitfalls to be aware of, and how technology and innovation may improve checklist and cognitive aid relevance and usability. Recent findings It has been difficult to show a direct link between the use of checklists alone and patient outcomes, but simulation studies have repeatedly demonstrated an association between checklist or cognitive aid use and improved performance. When implemented as pa...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Daniel Arna Source Type: research

Extension of patient safety initiatives to perioperative care
Purpose of review Patient safety has significantly improved during the intraoperative period thanks to the anesthesiologists, surgeons, and nurses. Nowadays, it is within the perioperative period where most of the preventable harm happened to the surgical patient. We aim to highlight the main issues and efforts to improve perioperative patient safety focusing and the relation to intraoperative safety strategies. Recent findings There is ongoing research on perioperative safety strategies aiming to initiate multidisciplinary interventions on early stages of the perioperative period as well as an increasing focus ...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Daniel Arna Source Type: research

Development and implementation of databases to track patient and safety outcomes
Purpose of review Recent advancements in big data analytical tools and large patient databases have expanded tremendously the opportunities to track patient and safety outcomes. We discuss the strengths and limitations of large databases and implementation in practice with a focus on the current opportunities to use technological advancements to improve patient safety. Recent findings The most used sources of data for large patient safety observational studies are administrative databases, clinical registries, and electronic health records. These data sources have enabled research on patient safety topics ran...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Daniel Arna Source Type: research

Regional anaesthesia: what surgical procedures, what blocks and availability of a “block room”?
Purpose of review With an expected rise in day care procedures with enhanced recovery programs, the use of specific regional anaesthesia can be useful. In this review, we will provide insight in the used regional block and medication so far known and its applicability in a day care setting. Recent findings Regional anaesthesia has been improved with the aid of ultrasound-guided placement. However, it is not commonly used in the outpatient setting. Old, short acting local anaesthetics have found a second life and may be especially beneficial in the ambulatory setting replacing more long-acting local anaesthetics ...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Ambulatory anesthesia and discharge: an update around guidelines and trends
Purpose of review Provide an oversight of recent changes in same-day discharge (SDD) of patient following surgery/anesthesia. Recent findings Enhanced recovery after surgery pathways in combination with less invasive surgical techniques have dramatically changed perioperative care. Preparing and optimizing patients preoperatively, minimizing surgical trauma, using fast-acting anesthetics as well as multimodal opioid-sparing analgesia regime and liberal prophylaxis against postoperative nausea and vomiting are basic cornerstones. The scope being to maintain physiology and minimize the impact on homeostasis and su...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Pain treatment and prophylaxis on pain
Purpose of review Also in ambulatory surgery, there will usually be a need for analgesic medication to deal with postoperative pain. Even so, a significant proportion of ambulatory surgery patients have unacceptable postoperative pain, and there is a need for better education in how to provide proper prophylaxis and treatment. Recent findings Postoperative pain should be addressed both pre, intra- and postoperatively. The management should be with a multimodal nonopioid-based procedure specific guideline for the routine cases. In 10–20% of cases, there will be a need to adjust and supplement the basic guidelin...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Scheduling staff for ambulatory anaesthesia
In this study, we summarize six articles published from January 2020 through June 2022 covering anaesthesia staff scheduling and consider their relevance to ambulatory surgery. Staff scheduling refers to the planned shift length of each person working on specific dates. Recent findings Increasing shift lengths compensates for COVID-19 pandemic staffing issues by reducing patient queues and mitigating the impact of staff absence from SAR-CoV-2 infection. Reduced labour costs can often be achieved by regularly scheduling more practitioners than expected from intuition. Probabilities of unscheduled absences, estimated ...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Preoperative anxiety
Purpose of review With first research reports dating back to the 1970s, the important role of anxiety in the perioperative period has been recognized for a long time and remains in effect. Recent findings The global pooled prevalence of preoperative anxiety among 14 000 surgical patients was reported to be 48%. The underlying fears among surgical patients include: fear of surgical complications, worry about the duration and degree of disability after the procedure, concerns about general anesthesia and the associated loss of control, as well as fear of waking up and experiencing discomfort and pain during or a...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Preoperative exercise and prehabilitation
Purpose of review The purpose of this narrative review is to give an overview about the effects of multimodal prehabilitation and current existing and prospectively planned studies. The potential efficacy of exercise in the context of prehabilitation ranges from preoperatively improving patients’ functional capacity to inducing cellular mechanisms that affect organ perfusion via endothelial regeneration, anti-inflammatory processes and tumour defense. Recent findings Current studies show that prehabilitation is capable of reducing certain postoperative complications and length of hospital stay in certain patie...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Modern preoperative evaluation in ambulatory surgery – who, where and how?
Purpose of review Ambulatory surgery is increasingly performed in medically complex patients. This dynamic environment requires new approaches to ensure cost-effective, efficient, and ultimately safe preoperative evaluation of the patient. This review investigates recent advances in the assessment of ambulatory patients, with a special focus on patient screening, digital communication, and multidisciplinary team evaluation. Recent findings Identifying suitable candidates for ambulatory surgery relies on a variety of medical, surgical, and institutional factors. Identification of high-risk patients and optimizati...
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: AMBULATORY ANAESTHESIA: Edited by Peter Kranke and Leopold Eberhart Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Anaesthesiology)
Source: Current Opinion in Anaesthesiology - October 29, 2022 Category: Anesthesiology Tags: EDITORIAL INTRODUCTIONS Source Type: research

A modern roadmap for the use of simulation in regional anesthesiology training
Purpose of review A variety of educational modalities are used to teach regional anesthesia. Simulation is an educational tool that facilitates hands-on learning in a well tolerated, reproducible environment, eliminating potential harm to patients during the process of learning. Available literature and expert consensus statements support customizing simulation programs according to the level of training and experience of the learners. Recent findings Simulation is useful for learners of all levels of expertise, though the application and frequency of simulation must be adapted to meet the learners’ objectives...
Source: Current Opinion in Anaesthesiology - September 7, 2022 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Ellen Soffin Source Type: research

Regional anesthesia global health collaborations- a scoping review of current intervention methods
Purpose of review Perioperative anesthesia-related mortality is significantly higher in low-resource compared to high-resource countries. Regional anesthesia techniques can provide safety, cost, and access benefits when compared to general anesthesia in these settings but is underutilized primarily due to a lack of experienced educators and training opportunities. Academic institutions and international organizations are attempting to fill this educational gap through collaborations, but these efforts need examination for best practices going forward. Recent findings Most collaborative anesthesia interactions be...
Source: Current Opinion in Anaesthesiology - September 7, 2022 Category: Anesthesiology Tags: REGIONAL ANESTHESIA: Edited by Ellen Soffin Source Type: research