Treatment of iron deficiency in patients scheduled for pancreatic surgery: implications for daily prehabilitation practice in pancreatic surgery
ConclusionID is prevalent in patients scheduled for pancreatic surgery and is amendable to preoperative correction. Preoperative IVIS increased Hb levels effectively and reduced postoperative SSI. Screening and correction of ID is an important element of preoperative care and should be a standard item in daily prehabilitation practice. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 11, 2023 Category: Surgery Source Type: research
Perioperative redox changes in patients undergoing hepato-pancreatico-biliary cancer surgery
ConclusionIn patients undergoing major HPB surgery, intraoperative oxidative and nitrosative stress increased, with a concomitant increase in reductive capacity. Baseline nitrate was inversely associated with postoperative morbidity, and the hallmarks of poor postoperative outcome include changes in both oxidative stress and NO metabolism. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 10, 2023 Category: Surgery Source Type: research
The effect of intraoperative goal-directed fluid therapy combined with enhanced recovery after surgery program on postoperative complications in elderly patients undergoing thoracoscopic pulmonary resection: a prospective randomized controlled study
ConclusionsUnder ERAS program, there was no significant difference of AKI incidence between GDFT and RFT in elderly patients undergoing thoracoscopic pulmonary resection. But postoperative increase degree of serum creatinine was lower in GDFT group.Trial registrationRegistered at ClinicalTrials.gov, NCT04302467 on 26 February 2020. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 10, 2023 Category: Surgery Source Type: research
Process, structural, and outcome quality indicators to support perioperative opioid stewardship: a rapid review
AbstractOpioids are effective analgesics but can cause harm. Opioid stewardship is key to ensuring that opioids are used effectively and safely. There is no agreed set of quality indicators relating to the use of opioids perioperatively. This work is part of the Yorkshire Cancer Research Bowel Cancer Quality Improvement programme and aims to develop useful quality indicators for the improvement of care and patient outcomes at all stages of the perioperative journey.A rapid review was performed to identify original research and reviews in which quality indicators for perioperative opioid use are described. A data tool was d...
Source: Perioperative Medicine - July 10, 2023 Category: Surgery Source Type: research
Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial
ConclusionsOur results suggested that a large randomized trial evaluating the effects of GDHT on the incidence of postoperative complications in elective neurosurgery should be safe and feasible. The rate of postoperative complications was comparable between groups.Trial registrationTrial registration: ClininalTrials.gov, registration number: NCT04754295, date of registration: February 15, 2021. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 5, 2023 Category: Surgery Source Type: research
Cardiopulmonary exercise testing before and after intravenous iron in preoperative patients: a prospective clinical study
ConclusionPreoperative administration of intravenous iron to iron-deficient/deplete anemic patients is associated with increases in [Hb], tHb-mass, peak oxygen consumption, and peak work rate. Further appropriately powered prospective studies are required to ascertain whether improvements in tHb-mass and performance in turn lead to reductions in perioperative morbidity.Trial registrationClinicalTrials.gov identifier: NCT 033 46213. (Source: Perioperative Medicine)
Source: Perioperative Medicine - July 3, 2023 Category: Surgery Source Type: research
A preoperative ultrasound-based protocol for optimisation of fluid therapy to prevent early intraoperative hypotension: a randomised controlled study
ConclusionWe implemented a safe and effective point-of-care ultrasound-based preoperative fluid replacement protocol into perioperative care.Trial registrationThe study was registered to ClinicalTrials.gov on 10/12/2021, registration number: NCT05171608 (registered prospectively on 10/12/2021). (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 27, 2023 Category: Surgery Source Type: research
Incidence of intraoperative hypotension during non-cardiac surgery in community anesthesia practice: a retrospective observational analysis
ConclusionIntraoperative hypotension is common in community anesthesia practice, including among patients and settings typically considered “low risk.” Variation in incidence across clinicians remains after risk-adjustment, suggesting that IOH is a modifiable risk worth pursuing in quality improvement initiatives. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 24, 2023 Category: Surgery Source Type: research
Postoperative rehospitalization in older surgical patients: an age-stratified analysis
ConclusionWe observed a decrease in overall rehospitalization for older surgical patients compared to studies a decade ago. The oldest ( ≥ 75) surgical patients had the highest 30-day rehospitalization rates (9.50%). The single most common reason for rehospitalization was the same across age groups and likely attributed to surgery (ileus). However, the aggregate of medical causes of rehospitalization was more common in older pati ents; surgical and respiratory reasons were twice as common in this group. Rehospitalization increased by age for some surgery types, e.g., lower extremity bypass, more than others, e.g., vent...
Source: Perioperative Medicine - June 21, 2023 Category: Surgery Source Type: research
Comparison of tramadol and lornoxicam for the prevention of postoperative catheter-related bladder discomfort: a randomized controlled trial
ConclusionsTramadol and lornoxicam administered intravenously at the end of the surgery were both effective in preventing the incidence and severity of CRBD after uterine surgery. However, tramadol increased the incidence of nausea compared with saline, but there was no difference between tramadol and lornoxicam.Trial registrationChiCTR2100052003. Registered on 12/10/2021. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 19, 2023 Category: Surgery Source Type: research
Preoperative assessment and optimisation prior to planned aortic aneurysm repair: a UK survey examining current practice and attitudes of vascular surgeons and vascular anaesthetists
ConclusionsDespite initiatives such as Getting It Right First Time (GIRFT) and National Institute for Health and Care Excellence (NICE) guidelines, variation still exists between centres with some differences in opinion observed between surgeons and anaesthetists. These differences may be leading to duplication of work in the perioperative pathway, inconsistencies in how risk is assessed and communicated with consequent variation in patient care. Addressing these issues requires awareness and implementation of existing guidelines, transdisciplinary working, efficient data-driven pathways, and structured aortic aneurysm mul...
Source: Perioperative Medicine - June 13, 2023 Category: Surgery Source Type: research
Review of cancer therapies for the perioperative physician
AbstractAdvances in cancer treatments over the past decades combining chemotherapy with novel technologies in immunotherapies, radiation therapies, and interventional radiology have prolonged life expectancy. Patients have more options for treatments of their primary or metastatic diseases. Increased procedural techniques amid an aging population with multiple comorbidities present risks and challenges in the perioperative period.Chemotherapy remains the mainstay of cancer treatment, can be given intraoperatively, and is combined with other treatment modalities. Immunotherapy is particular to cancer cells while being less ...
Source: Perioperative Medicine - June 13, 2023 Category: Surgery Source Type: research
A comparative study on the effect of dopamine vs phenylephrine in improving the cutaneous analgesic effect of mexiletine in rats
ConclusionDopamine is superior to phenylephrine in improving sensory blockage and enhancing the duration of nociceptive blockage by mexiletine. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 13, 2023 Category: Surgery Source Type: research
The effect of restrictive vs. liberal fluid protocols on ocular parameters in patients undergoing prone spine surgery: a randomized controlled trial
ConclusionsCompared to the restrictive fluid protocol, the liberal fluid protocol increased IOP but not ONSD in patients undergoing prone spine surgery.Trial registrationThe study was registered in ClinicalTrials.gov (https://clinicaltrials.gov) prior to patient enrollment, ID: NCT03890510, on March 26, 2019. The principal investigator was Xiao-Yu Yang. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 12, 2023 Category: Surgery Source Type: research
The relationship between fear of surgery and affecting factors in surgical patients
ConclusionAccording to the results of this study, it has been determined that the emotional states and fears of the patients before the surgery have significant effects on the fear of surgery. For this, it is recommended to determine the emotional states and fears of the patients before the surgery and to make appropriate interventions, as it will facilitate compliance with the surgical process. (Source: Perioperative Medicine)
Source: Perioperative Medicine - June 9, 2023 Category: Surgery Source Type: research
