Sufentanil sublingual tablet system for enhanced recovery after total knee arthroplasty: a prospective observational case study
ConclusionIn our center, the use of a SSTS was suitable for treating postoperative pain after knee arthroplasty, but it did not improve early recovery in comparison with a morphine PCA. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 4, 2022 Category: Surgery Source Type: research
The impact of spinal anaesthesia on perioperative opioid consumption, postoperative pain and oncological outcome in radical retropubic prostatectomy —a retrospective before-and-after effectiveness study
ConclusionsSpinal anaesthesia preceding general anaesthesia for RRP is associated with increased postoperative opioid consumption compared to general anaesthesia alone. Postoperative pain level and the oncological outcome are not affected by the adjunctive use of spinal anaesthesia. Thus, the addition of spinal anaesthesia to general anaesthesia has no advantage in RRP.Trial registrationClinicalTrial.gov, NCT03565705. (Source: Perioperative Medicine)
Source: Perioperative Medicine - October 3, 2022 Category: Surgery Source Type: research
The Marsden Morbidity Index: the derivation and validation of a simple risk index scoring system using cardiopulmonary exercise testing variables to predict morbidity in high-risk patients having major cancer surgery
ConclusionOur study showed that of the CPET variables, AT, VO2 max, and AT VE/VCO2 were shown to be associated with postoperative surgical morbidity following major abdominal oncological surgery. When combined with a number of preoperative comorbidities commonly associated with increased risk of postoperative morbidity, we created a useful institutional scoring system for predicting which patients will experience adverse events. However, this system needs further validation in other centres performing oncological surgery. (Source: Perioperative Medicine)
Source: Perioperative Medicine - September 22, 2022 Category: Surgery Source Type: research
Perioperative statin medication impairs pulmonary outcome after abdomino-thoracic esophagectomy
ConclusionsDevelopment of pulmonary complications after abdomino-thoracic esophagectomy is multifactorial but frequent. The establishment of preventive measures into the perioperative clinical routine is mandatory for an improved patient outcome. Perioperative medication with statins might influence pneumonia development in the highly vulnerable lung after abdomino-thoracic esophagectomy. Perioperative interruption of statin medication might be beneficial in appropriate patients; however, further clinical trials and translational studies are needed to prove this hypothesis. (Source: Perioperative Medicine)
Source: Perioperative Medicine - September 14, 2022 Category: Surgery Source Type: research
Frequency and costs of low-value preoperative tests for patients undergoing low-risk procedures in the veterans health administration
ConclusionsRoutine preoperative screening tests for very low-risk procedures are common and costly in some VA facilities. These results highlight a potential target to improve quality and value by reducing unnecessary care. Measures of low-value perioperative care could be integrated into VA ’s extensive quality monitoring and improvement infrastructure. (Source: Perioperative Medicine)
Source: Perioperative Medicine - September 13, 2022 Category: Surgery Source Type: research
Effect of the preoperative physical status on postoperative nausea and vomiting risk: a matched cohort study
ConclusionThere were differences in intraoperative invasive monitoring and use of vasopressor or inotrope among the classifications, and a score of 3 or higher reduced the risk of postoperative nausea and vomiting more than a score of 1 –2. (Source: Perioperative Medicine)
Source: Perioperative Medicine - September 6, 2022 Category: Surgery Source Type: research
A scoping review of local quality improvement using data from UK perioperative National Clinical Audits
ConclusionsThere is limitedpublic reporting of UK perioperative NCA data for local QI, despite evidence of improvement of most NCA metrics at the national level. It is therefore unclearhow these improvements are being made, and it is likely that opportunities are being missed to share learning between local sites. We make recommendations for how NCAs could better support the conduct, evaluation and reporting of local QI and suggest topics which future research should investigate.Trial registrationThe review was registered with the International Prospective Register of Systematic Reviews (PROSPERO:CRD42018092993). (Source: ...
Source: Perioperative Medicine - August 29, 2022 Category: Surgery Source Type: research
Frailty in the over 65 ’s undergoing elective surgery (FIT-65) – a three-day study examining the prevalence of frailty in patients presenting for elective surgery
ConclusionWe found the prevalence of frailty in a mixed population of elective surgical patients aged 65 or over to be 17.0%. Furthermore, we found the REFS to be a practical tool for pre-operative frailty screening. Frail patients presented for elective surgery with modifiable co-morbidities which could have been optimised pre-operatively. Early screening could highlight frail patients, allowing time for pre-operative planning and evidence-based optimisations of comorbidities. We therefore encourage the adoption of frailty assessment as a routine part of pre-operative assessment. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 25, 2022 Category: Surgery Source Type: research
Prehabilitation in high-risk patients scheduled for major abdominal cancer surgery: a feasibility study
ConclusionOur prehabilitation program in high-risk cancer surgery patients did not achieve pre-specified targets for recruitment, retention, and self-reported program adherence. These findings underpin the importance of implementation research and strategies for the prehabilitation programs in major surgery.Trial registrationAustralian New Zealand Clinical Trials Registry (ACTRN12620000073909) retrospectively registered. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 23, 2022 Category: Surgery Source Type: research
In-hospital mortality of patients requiring unplanned postoperative ventilatory support: a multicenter observational study
ConclusionUnplanned postoperative mechanical ventilation is associated with noteworthy morbidity and mortality, with significantly higher rates in those of need for protracted (vs. short) mechanical ventilation. The remarkable mortality rate in patients extubated shortly after arriving to the PACU emphasizes the need for further studies to explore prompting factors and whether we can intervene to improve patients ’ outcome. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 23, 2022 Category: Surgery Source Type: research
Postoperative kinetics of pentraxin 3 (PTX3) after congenital heart surgery with cardiopulmonary bypass in pediatric patients
ConclusionsPTX3 concentrations are markedly elevated during the first postoperative day. Under normal circumstances, PTX3 rises and falls quickly, and its second rise in the early postoperative period may be abnormal, however, further studies are necessary. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 22, 2022 Category: Surgery Source Type: research
Postoperative short-term use of the nonsteroidal anti-inflammatory drug flurbiprofen did not increase the anastomotic leakage rate in patients undergoing elective gastrointestinal surgery —a retrospective cohort study
ConclusionsPostoperative short-term use of flurbiprofen did not increase the risk of anastomotic leakage in gastrointestinal anastomoses. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 19, 2022 Category: Surgery Source Type: research
A proposal for virtual, telephone-based preoperative cognitive assessment in older adults undergoing elective surgery
ConclusionPreoperative cognitive assessment of older adults using T-MoCA over the phone is easy to perform by clinicians and had a high completion rate by patients. This test is feasible for virtual assessments. Further research is needed to better define validity and correlation with postoperative outcomes. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 18, 2022 Category: Surgery Source Type: research
Predictors of low cardiac output after isolated pericardiectomy: an observational study
ConclusionsEarly recognition and management of hyponatremia, renal dysfunction, fluid retention, and hyperbilirubinemia may benefit constrictive pericarditis patients after pericardiectomy. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 17, 2022 Category: Surgery Source Type: research
The effect of opioid-sparing anesthesia regimen on short-term cognitive function after thoracoscopic surgery: a prospective cohort study
ConclusionsMiddle-aged people and low levels of education are independent risk factors for delayed neurocognitive recovery after thoracoscopic surgery. ESPB has the potential to prevent cognitive decline in high-risk patients.Trial registrationChiCTR1800014508 (www.chictr.org.cn, January 17, 2018; Hong Zhao, M.D.). URL:http://www.chictr.org.cn/showproj.aspx?proj=24778. The date of the enrolment of the first participant to the trial was January 22, 2018. (Source: Perioperative Medicine)
Source: Perioperative Medicine - August 16, 2022 Category: Surgery Source Type: research
