Barriers and facilitators of following perioperative internal medicine recommendations by surgical teams: a sequential, explanatory mixed-methods study
ConclusionsOnly 55.7% of consult notes had all recommendations followed, suggesting a quality gap in perioperative medical care. Qualitative data suggests multiple drivers of missed recommendations that should be targeted to improve the efficiency of care for these patients. (Source: Perioperative Medicine)
Source: Perioperative Medicine - February 1, 2022 Category: Surgery Source Type: research
Utility and reliability of the Clinical Frailty Scale in patients scheduled for major vascular surgery: a prospective, observational, multicentre observer-blinded study
ConclusionsThe Clinical Frailty Scale is a useful tool to assess frailty in the vascular surgical population. It is more practical than the Edmonton Frailty Scale: quick to complete, requires minimal training and can be used when physical disability is present.Trial registrationThe study was approved by the Wales Health and Care Research Ethics Service (REC reference 17/WA/0160, IRAS 201173). Trial registration: NCT03403673. Registered 19 January 2018,https://clinicaltrials.gov/ct2/show/NCT03403673 (Source: Perioperative Medicine)
Source: Perioperative Medicine - January 31, 2022 Category: Surgery Source Type: research
Clinical characteristics and allergen detection of perioperative anaphylaxis: a 12-year retrospective analysis from an anesthesia clinic in China
ConclusionsThis study suggests that neuromuscular blocking agents are the main cause of perioperative anaphylaxis. For patients with perioperative anaphylaxis, allergy diagnostic tests are essential to identify causative agents, and to find suitable alternative drugs for the future planning of subsequent anesthetics. (Source: Perioperative Medicine)
Source: Perioperative Medicine - January 21, 2022 Category: Surgery Source Type: research
Impact on grafted kidney function of rocuronium-sugammadex vs cisatracurium-neostigmine strategy for neuromuscular block management. An Italian single-center, 2014-2017 retrospective cohort case-control study
ConclusionsCompared to cisatracurium-neostigmine, the rocuronium-sugammadex strategy for reversal of NMB showed a better recovery profile in patients undergoing kidney transplantation. (Source: Perioperative Medicine)
Source: Perioperative Medicine - January 13, 2022 Category: Surgery Source Type: research
Does application of honey improve surgical outcome in pilonidal cyst excision with secondary intention healing? A prospective randomized placebo-controlled clinical trial
ConclusionsApplication of honey after resection surgery with secondary wound healing is associated with a better surgical outcome and could eventually decrease healing time and reduce duration of return to normal activities, but could increase post-operation pain and analgesic consumption, and no effect on foul smell and discharge.Trial registrationThe project was found to be in accordance to the ethical principles and the national norms and standards for conducting research in Iran with the approval ID and date ofIR.YUMS.REC.1399.088 and 2020.05.30 respectively, and is the result of a residency dissertation to get the spe...
Source: Perioperative Medicine - January 10, 2022 Category: Surgery Source Type: research
The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study
ConclusionsPatients with femoral fractures require a nutritional assessment and appropriate nutritional intervention at admission, and that the PNI value at admission may be a good nutritional assessment indicator. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 20, 2021 Category: Surgery Source Type: research
Comparison of restrictive fluid therapy with goal-directed fluid therapy for postoperative delirium in patients undergoing spine surgery: a randomized controlled trial
ConclusionsGDT reduced the incidence of POD in middle- and old-aged patients undergoing spinal surgery possibly by stabilizing perioperative hemodynamic and improving the supply and demand of oxygen.Trial registrationChiCTR2000032603; Registered on May 3, 2020. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 15, 2021 Category: Surgery Source Type: research
Readmissions after elective orthopedic surgery in a comprehensive co-management care system —a retrospective analysis
ConclusionRates of UROR during initial hospitalization and readmission were lower in the current study than described in the literature. However, several comorbidities and surgery-related risk factors were found to be associated with these events. Although no surgery is without risk, known threats should be reduced and every effort undertaken to minimize complications in high-risk populations. Further prospective controlled research is needed to investigate the potential benefits of a co-management model in elective orthopedic surgery. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 15, 2021 Category: Surgery Source Type: research
Color Doppler ultrasonography of an agitated solution is predictive of accurate catheter placement for a continuous popliteal sciatic nerve block
ConclusionsInjection of an agitated solution through a popliteal sciatic perineural catheter is predictive of accurate catheter placement when partial or complete coverage of the sciatic nerve branches is visualized with color Doppler ultrasound.Trial registrationNCT01591603 (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 15, 2021 Category: Surgery Source Type: research
New surgical realities: implementation of an enhanced recovery after surgery protocol for gynecological laparoscopy —a prospective study
ConclusionsThe ERAS protocol is applicable in laparoscopic gynecological surgery and can be implemented with good adherence. This can allow optimization of patient recovery by reducing the hospital stay duration, without increasing the rates of morbidity, mortality, or readmission. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 15, 2021 Category: Surgery Source Type: research
The potential for artificial intelligence to predict clinical outcomes in patients who have acquired acute kidney injury during the perioperative period
AbstractAcute kidney injury (AKI) is a common medical problem in hospitalised patients worldwide that may result in negative physiological, social and economic consequences. Amongst patients admitted to ICU with AKI, over 40% have had either elective or emergency surgery prior to admission. Predicting outcomes after AKI is difficult and the decision on whom to initiate RRT with a goal of renal recovery or predict a long-term survival benefit still poses a challenge for acute care physicians. With the increasing use of electronic healthcare records, artificial intelligence may allow postoperative AKI prognostication and aid...
Source: Perioperative Medicine - December 15, 2021 Category: Surgery Source Type: research
The association of multimodal analgesia and high-risk opioid discharge prescriptions in opioid-naive surgical patients
ConclusionProviders should account for pre-discharge opioid consumption and use of multimodal analgesia when considering the total and daily OME ’s that may be appropriate for an individual surgical patient on the discharge opioid prescription. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 15, 2021 Category: Surgery Source Type: research
Mortality and associated risk factors in perioperative acute kidney injury treated with continuous renal replacement therapy
ConclusionsPatients undergoing surgery and requiring perioperative CRRT in the ICU have a high risk of mortality. Mortality appears to be independently associated with lactate levels. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 14, 2021 Category: Surgery Source Type: research
The efficacy and safety of antimuscarinics for the prevention or treatment of catheter-related bladder discomfort: a systematic review and meta-analysis of randomized controlled trials
ConclusionsCompared with the control group, the antimuscarinics group had a significant improvement on CRBD, the patients were well tolerated and the use rate of rescue analgesics was low. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 14, 2021 Category: Surgery Source Type: research
Comparison of different scales for the evaluation of anxiety and compliance with anesthetic induction in children undergoing scheduled major outpatient surgery
ConclusionsStandard anxiety assessment scales do not predict the quality of anesthetic induction. m-YPAS scale can detect increasing anxiety in children as they approach the surgical procedure and this correlates strongly with a worse anesthetic induction, defined by higher score on ICC scale. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 14, 2021 Category: Surgery Source Type: research
