A retrospective evaluation of the impact of patient ethnicity on the use of epidural analgesia or blood transfusions in children undergoing major oncologic surgery
ConclusionIn this study of children who had undergone major oncologic surgery, the use of epidural analgesia or blood transfusions was not associated with patient ethnicity. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 19, 2019 Category: Surgery Source Type: research
The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial
ConclusionsThe medical treatment using virtual reality technology, as well as distraction and drowning in the virtual reality, reduced pre-operative anxiety in children. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 3, 2019 Category: Surgery Source Type: research
Enhanced recovery after surgery (ERAS) program for lumbar spine fusion
ConclusionsImplementing an ERAS bundle for 1–2-level lumbar fusion had minimal effect in decreasing length of stay, but a significant decrease in postoperative opioid and rescue antiemetic use. This ERAS bundle showed mixed results likely secondary to poor ERAS protocol compliance. Going forward, this QI project will look to improve post-operative ERAS implementation to improve patient outcomes. (Source: Perioperative Medicine)
Source: Perioperative Medicine - May 27, 2019 Category: Surgery Source Type: research
Factors influencing day surgery patients ’ quality of postoperative recovery and satisfaction with recovery: a narrative review
The objective of this paper is to discuss and reflect on factors that can affect patients’ quality of postoperative recovery and satisfaction with recovery after day surg ery. Involving patients in shared decision-making (SDM) and providing sufficient preoperative and postoperative information can improve their satisfaction. It is important to assess whether patients experience poor recovery, which can be both distressing and dissatisfying. We suggest that patients’ age, sex, mental health status, and health literacy (HL) skills should be assessed preoperatively, since these factors seem to have a negative impact on pa...
Source: Perioperative Medicine - May 21, 2019 Category: Surgery Source Type: research
Intravenous lidocaine infusion as a component of multimodal analgesia for colorectal surgery —measurement of plasma levels
ConclusionsWhilst there were no signs or symptoms of lidocaine toxicity in our patients, there was a wide range of plasma concentrations including some over 10 μg ml−1; a level above which symptoms of toxicity may be expected. We have changed our dosing protocol to using ideal rather than actual body weight based on these results. (Source: Perioperative Medicine)
Source: Perioperative Medicine - February 26, 2019 Category: Surgery Source Type: research
Anesthetic consideration for airway management of patients undergoing endoscopic fibrin glue treatment of tracheobronchial rupture: a case series of three patients
AbstractTracheobronchial ruptures are very severe and life-threatening injuries. The origin of such airway damage is trauma or an iatrogenic event. Last year, we operated on three different cases of tracheal ruptures using endobronchial suture with three different airway management. We exposed the description of three different techniques to manage the airway during an endoscopic suture of tracheobronchial rupture with fibrin glue (laryngeal mask, orotracheal tube positioned distally the lesion, one lung ventilation with a small size single tube). Using this kind of technique, we have obtained a protective ventilation on t...
Source: Perioperative Medicine - December 17, 2018 Category: Surgery Source Type: research
Acute kidney injury in postoperative shock: is hyperoncotic albumin administration an unrecognized resuscitation risk factor?
ConclusionsEarly exposure to hyperoncotic albumin in postoperative shock appeared to be associated with acute kidney injury. There did not appear to be any association with hepatic injury, mortality, or ICU days. The clinical and economic implications of this finding warrant further investigation. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 14, 2018 Category: Surgery Source Type: research
Perioperative administration of buffered versus non-buffered crystalloid intravenous fluid to improve outcomes following adult surgical procedures: a Cochrane systematic review
ConclusionsSmall effect sizes for biochemical outcomes and lack of correlated clinical follow-up data mean that robust conclusions on major morbidity and mortality associated with buffered versus non-buffered perioperative fluid choices are still lacking. Buffered fluid may have biochemical benefits, including a significant reduction in postoperative hyperchloraemia and metabolic acidosis. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 13, 2018 Category: Surgery Source Type: research
What is the effect of perioperative intravenous iron therapy in patients undergoing non-elective surgery? A systematic review with meta-analysis and trial sequential analysis
ConclusionWe found no conclusive evidence of an effect of IV iron on clinically important outcomes in patients undergoing non-elective surgery. Further adequately powered trials to evaluate its benefit in emergency surgical specialties with a high burden of anaemia are warranted.Trial registrationThis systematic review was registered on PROSPERO (CRD42018096288) (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 12, 2018 Category: Surgery Source Type: research
Characterizing post-extubation negative pressure pulmonary edema in the operating room —a retrospective matched case-control study
ConclusionWe present the first clinical comparative study demonstrating that the overall incidence of NPPE immediately after extubation in the operating room is 0.019%. Our results highlight that active smokers and patients receiving endotracheal intubation general anesthesia are associated with significantly higher risks of developing NPPE following extubation in the operating room. (Source: Perioperative Medicine)
Source: Perioperative Medicine - December 6, 2018 Category: Surgery Source Type: research
Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule.
ConclusionA combination of variables significantly predicted chronic opioid use in this cohort. Most of these variables were mediators, indicating that modifying them may be feasible, and the potential focus of interventions to decrease the risk of chronic opioid use, or at minimum better inform opioid prescribing decisions. This clinical prediction rule needs further validation. (Source: Perioperative Medicine)
Source: Perioperative Medicine - November 22, 2018 Category: Surgery Source Type: research
A prospective case series evaluating use of an in-line air detection and purging system to reduce air burden during major surgery
ConclusionAn air purging system reduced air burden from bolus administration and could consequently reduce the risk of harmful or fatal AEs during surgery. (Source: Perioperative Medicine)
Source: Perioperative Medicine - November 8, 2018 Category: Surgery Source Type: research
Pulmonary artery catheter use in adult patients undergoing cardiac surgery: a retrospective, cohort study
ConclusionsUse of a PAC during adult cardiac surgery is associated with decreased length of stay, reduced cardiopulmonary morbidity, and increased infectious morbidity but no increase in the 30-day in-hospital mortality. This suggests an overall potential benefit associated with PAC-based monitoring in this population.Trial registrationThe study was registered atclinicaltrials.gov (NCT02964026) on November 15, 2016. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 25, 2018 Category: Surgery Source Type: research
Correction to: Intraoperative oxygenation in adult patients undergoing surgery (iOPS): a retrospective observational study across 29 UK hospitals
Following publication of the original article (Morkane et al., 2018), it was noticed that the second collaborating group ‘South Coast Perioperative Audit and Research Collaboration (SPARC)’ was not displayed on the HTML online version due to an error by the Publisher. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 24, 2018 Category: Surgery Source Type: research
Clinical and economic impact of goal-directed fluid therapy during elective gastrointestinal surgery
ConclusionIn patients undergoing gastrointestinal surgery, the implementation of a GDFT protocol was associated with a reduction in postoperative morbidity without increasing costs.Trial registrationclinicaltrials.gov,NCT02507557. Registered 13 July 2015. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 4, 2018 Category: Surgery Source Type: research
