Clinical covariates that improve surgical risk prediction and guide targeted prehabilitation: an exploratory, retrospective cohort study of major colorectal cancer surgery patients evaluated with preoperative cardiopulmonary exercise testing
ConclusionConsideration of modifiable ‘triple low’ preoperative risk (anaemia, malnutrition, deconditioning) factors and inflammation will improve surgical risk prediction and guide prehabilitation. Gas exchange parameters that focus on VCO2 kinetics at AT and correcting peakVO2 to body surface area (rather than absolute weight) may improve CPET-derived preoperative risk assessment. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 26, 2022 Category: Surgery Source Type: research
Effect of sedative premedication with oral midazolam on postanesthesia care unit delirium in older adults: a secondary analysis following an uncontrolled before-after design
ConclusionMidazolam for sedative premedication was not significantly associated with PACU delirium. The reduction in the incidence of PACU delirium throughout the study period may be attributable to improvements in perioperative management other than a more restrictive preoperative benzodiazepine administration. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 19, 2022 Category: Surgery Source Type: research
Effects of ramosetron orally disintegrating tablets on the prophylaxis of post-discharge nausea and/or vomiting in female patients undergoing day surgery under general anesthesia: a randomized controlled trial
ConclusionRamosetron ODT reduces the incidence and severity of postoperative nausea after discharge during the first 24 h and may be a valuable option for the prevention of PDNV in female patients after day surgery under general anesthesia.Trial registrationClinicalTrials.gov,NCT04297293. Registered on 05 March 2020 (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 12, 2022 Category: Surgery Source Type: research
Favorable effect of enhanced recovery programs on post-discharge mortality: a French nationwide study
ConclusionThe findings, based on a large database and a rigorous matching, strongly suggest that ERPs reduce PDM particularly after colectomy and hip arthroplasty. This is likely due to better post-operative care in ERPs. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 2, 2022 Category: Surgery Source Type: research
Controversies in enhanced recovery after cardiac surgery
AbstractAdvances in cardiac surgical operative techniques and myocardial protection have dramatically improved outcomes in the past two decades. An unfortunate and unintended consequence is that 80% of the preventable morbidity and mortality following cardiac surgery now originates outside of the operating room. Our hope is that a renewed emphasis on evidence-based best practice and standardized perioperative care will reduce overall morbidity and mortality and improve patient-centric care. The Perioperative Quality Initiative (POQI) and Enhanced Recovery After Surgery –Cardiac Society (ERAS® Cardiac) have identified si...
Source: Perioperative Medicine - April 28, 2022 Category: Surgery Source Type: research
The association between preoperative Mini-Cog © score and postoperative delirium (POD): a retrospective cohort study
ConclusionsMini-Cog © is not independently associated with post-operative delirium in high-risk elective colorectal surgery patients in this cohort. Mini-Cog© shows promise as a possible predictor of 90-day mortality. Larger studies exploring preoperative cognitive status and postoperative confusion and mortality cou ld improve risk-stratification for surgery and allocation of resources to those patients at higher risk. (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 21, 2022 Category: Surgery Source Type: research
Analgesic effect of iliopsoas plane block for hip fracture
ConclusionsOur case series firstly highlights that IPB might be an effective analgesic technique for hip fracture and surgery, while retaining motor function. (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 14, 2022 Category: Surgery Source Type: research
Huashan perioperative nursing program for stroke patients undergoing contralateral seventh cervical nerve transfer
This article introduces the Huashan nursing program, which is based on preoperative evaluations, educational sessions, postoperative monitoring, and targeted nursing, for patients undergoing CC7. This nursing program helped promote and provided the opportunity to maximize the benefits of CC7. (Source: Perioperative Medicine)
Source: Perioperative Medicine - April 7, 2022 Category: Surgery Source Type: research
What is the impact of dexamethasone on postoperative pain in adults undergoing general anaesthesia for elective abdominal surgery: a systematic review and meta-analysis
ConclusionsPatients receiving dexamethasone had reduced pain scores, postoperative opioid requirements and longer time to first analgesia. Dexamethasone is an effective analgesic adjunct for patients undergoing abdominal surgery. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 24, 2022 Category: Surgery Source Type: research
Psychological distress among elderly surgical patients who had their surgery postponed during the COVID-19 pandemic
ConclusionThe mental health and disease burden of older surgical patients should be taken into careful consideration when cases need to be postponed in our healthcare system. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 17, 2022 Category: Surgery Source Type: research
Maxillofacial free flap surgery outcomes in critical care: a single-center investigation looking for clues to improvement
ConclusionsPractices such as blood management and respiratory prehabilitation could be beneficial and should be evaluated as a part of global improvement strategies. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 10, 2022 Category: Surgery Source Type: research
Patient-health care provider relationship during preoperative care in obstetric and gynecologic surgeries at Jimma Medical Center, Jimma, Ethiopia: patient ’s perspective
ConclusionsThe proportion of patient-to healthcare providers ’ relationship was low. More than half of the respondents did not have good patient–health care provider relationship. Hence, health care providers should be concerned about their relationship with their patients to increase the quality of medical care. The health care providers should bear in m ind that patients may refuse to seek care from a provider whose relationship is not strong, even if the provider is skilled in preventing and managing complications. (Source: Perioperative Medicine)
Source: Perioperative Medicine - March 3, 2022 Category: Surgery Source Type: research
Perioperative fluid administration and complications in emergency gastrointestinal surgery —an observational study
ConclusionWe found a perioperative fluid balance above 2.5 L to be associated with an increased risk of overall and cardiopulmonary complications following emergency surgery for gastrointestinal obstruction or perforation. A perioperative fluid balance of 0–2 L was associated with the lowest risk of cardiopulmonary complications and 1.5–3.5 L for ren al complications. (Source: Perioperative Medicine)
Source: Perioperative Medicine - February 22, 2022 Category: Surgery Source Type: research
Postoperative decrease of albumin ( ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review
ConclusionΔAlb appeared as a valuable and promising biomarker to anticipate complications after gastrointestinal surgery. Future efforts are needed to determine whether and how ΔAlb may be integrated in clinical practice to guide clinicians in the perioperative management of patients. (Source: Perioperative Medicine)
Source: Perioperative Medicine - February 15, 2022 Category: Surgery Source Type: research
A protocol for prospective observational study to determine if non-anaemic iron deficiency worsens postoperative outcome in adult patients undergoing elective cardiac surgery: the IDOCS study
This study will be conducted using a rigorous, prospective observational design; it will provide peak bodies and clinicians with high-quality evidence concerning the associations between non-anaemic iron deficiency and patient-centred outcomes after elective cardiac surgery. Our primary and key secondary outcomes are known to have great importance to clinicians and patients alike and align with the recommendations of the StEP-COMPAC group for outcomes in prospective peri-operative research. The definition used for iron deficiency accounts for both absolute and functional iron deficiency and make use of standard pre-operati...
Source: Perioperative Medicine - February 8, 2022 Category: Surgery Source Type: research
