1,985 results match your criteria Perioperative Medication Management


Perioperative management of diabetes in patients undergoing bariatric and metabolic surgery: a narrative review and the Cleveland Clinic practical recommendations.

Surg Obes Relat Dis 2022 May 12. Epub 2022 May 12.

Endocrinology and Metabolism Institute, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio.

Bariatric and metabolic surgery is an effective treatment for patients with severe obesity and obesity-related diseases. In patients with type 2 diabetes, it provides marked improvement in glycemic control and even remission of diabetes. In patients with type 1 diabetes, bariatric surgery may offer improvement in insulin sensitivity and other cardiometabolic risk factors, as well as amelioration of the mechanical complications of obesity. Read More

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Error Traps in Acute Pain Management in Children.

Paediatr Anaesth 2022 Jun 25. Epub 2022 Jun 25.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.

Providing effective acute pain management to hospitalized children can help improve outcomes, decrease length of stay, and increase patient and parental satisfaction. Error traps (circumstances that lead to erroneous actions or undesirable consequences) can result in inadequately controlled pain, unnecessary side effects, and adverse events. This article highlights five error traps encountered when managing acute pain in children. Read More

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The effectiveness of ERAS guidelines in reducing postoperative pain.

Worldviews Evid Based Nurs 2022 Jun 23. Epub 2022 Jun 23.

University of North Florida, Brooks College of Health, School of Nursing, Nurse Anesthesiology Program, Jacksonville, Florida, USA.

Background: Poorly controlled acute postsurgical pain can promote chronic opioid use and misuse long after the initial surgical procedure. Enhanced recovery after surgery (ERAS) guidelines have shown promise in reducing opioid exposure and minimizing opioid-related side effects.

Aims: The aims of this evidence-based practice (EBP) project were to assess the ERAS literature to guide postoperative pain management practice change at an adult colorectal surgical unit, evaluate the practice change outcomes, and disseminate the findings. Read More

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2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.

J Arthroplasty 2022 Jun 17. Epub 2022 Jun 17.

University of Alabama at Birmingham and Veterans Affairs Medical Center, Birmingham, Alabama.

Objective: To develop updated American College of Rheumatology/American Association of Hip and Knee Surgeons guidelines for the perioperative management of disease-modifying medications for patients with rheumatic diseases, specifically those with inflammatory arthritis (IA) and those with systemic lupus erythematosus (SLE), undergoing elective total hip arthroplasty (THA) or elective total knee arthroplasty (TKA).

Methods: We convened a panel of rheumatologists, orthopedic surgeons, and infectious disease specialists, updated the systematic literature review, and included currently available medications for the clinically relevant population, intervention, comparator, and outcomes (PICO) questions. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence and the strength of recommendations using a group consensus process. Read More

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Management dilemma in metastatic papillary thyroid carcinoma.

N Z Med J 2022 Jun 10;135(1556):127-131. Epub 2022 Jun 10.

Department of Otolaryngology-Head and Neck Surgery, Waikato Hospital, New Zealand.

Papillary thyroid cancer is the most common type of well-differentiated thyroid cancer. It is associated with a survival rate greater than 95% with appropriate treatment, particularly in younger patients. We present the unique case of a 25-year-old male with severe Autistic spectrum disorder (ASD) with a right level V neck mass of several months. Read More

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2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.

Arthritis Rheumatol 2022 Jun 20. Epub 2022 Jun 20.

University of Alabama at Birmingham and Veterans Affairs Medical Center, Birmingham, Alabama.

Objective: To develop updated guidelines for the perioperative management of disease-modifying medications for patients with rheumatic diseases, specifically those with inflammatory arthritis (IA) and those with systemic lupus erythematosus (SLE), undergoing elective total hip arthroplasty (THA) or elective total knee arthroplasty (TKA).

Methods: We convened a panel of rheumatologists, orthopedic surgeons, and infectious disease specialists, updated the systematic literature review, and included currently available medications for the clinically relevant population, intervention, comparator, and outcomes (PICO) questions. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence and the strength of recommendations using a group consensus process. Read More

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2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.

Arthritis Care Res (Hoboken) 2022 Jun 19. Epub 2022 Jun 19.

University of Alabama at Birmingham and Veterans Affairs Medical Center, Birmingham, Alabama.

Objective: To develop updated guidelines for the perioperative management of disease-modifying medications for patients with rheumatic diseases, specifically those with inflammatory arthritis (IA) and those with systemic lupus erythematosus (SLE), undergoing elective total hip arthroplasty (THA) or elective total knee arthroplasty (TKA).

Methods: We convened a panel of rheumatologists, orthopedic surgeons, and infectious disease specialists, updated the systematic literature review, and included currently available medications for the clinically relevant population, intervention, comparator, and outcomes (PICO) questions. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence and the strength of recommendations using a group consensus process. Read More

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Perioperative characteristics, histologic diagnosis, complications, and outcomes of dogs undergoing percutaneous drainage, sclerotherapy or surgical management of intrarenal cystic lesions: 18 dogs (2004-2021).

BMC Vet Res 2022 Jun 20;18(1):233. Epub 2022 Jun 20.

Department of Small Animal Surgery, Section of Small Animal Clinical Studies, University College Dublin, Belfield, Dublin 4, Ireland.

Background: Canine intrarenal cystic lesions (ICLs) are infrequently reported in the veterinary literature. Several treatment options have been described including cyst fenestration (partial nephrectomy/deroofing) +/- omentalization, sclerotherapy using alcohol as a sclerosing agent, percutaneous cyst drainage (PCD), and ureteronephrectomy. Information regarding presenting clinical signs, physical examination findings, histologic diagnosis and outcomes of dogs with ICLs treated by different methods is limited. Read More

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IUA position statement on perioperative drug and hemostasis management in vascular surgery.

Int Angiol 2022 Jun 15. Epub 2022 Jun 15.

Vascular Centre, Nuova Villa Claudia, Rome, Italy.

This position paper, written by members of International Union of Angiology (IUA) Youth Committee, shows an overview of coagulation system and laboratory tests, analysis of medical therapies (older and newer), medication discontinuation/restart recommendations, bridging therapy recommendations, and an overview of hemostatic agents used in the operating room. Read More

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Factors associated with heroin use among those reporting -prescription opioid misuse: Results from a nationally -representative sample.

J Opioid Manag 2022 May-Jun;18(3):243-255

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts. ORCID: https://orcid.org/0000-0002-0516-5977.

Objective: The present investigation aims to identify characteristics associated with heroin use among those reporting prescription opioid misuse from a nationally representative sample, and how these characteristics vary by urbanicity.

Design: A cross-sectional analysis.

Setting: Pooled 2015-2018 data from the National Survey on Drug Use and Health (NSDUH), the leading source for nationally representative substance use, mental health, and other health-related data and trends in the United States. Read More

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Multiple Opioid Prescribers During the Perioperative Period Increases Opioid Consumption Following Upper Extremity Surgery: A Multicenter Analysis.

Cureus 2022 Apr 27;14(4):e24541. Epub 2022 Apr 27.

Department of Orthopaedics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA.

Background Opioid prescribing practices have been an area of interest for orthopedic surgeons in the wake of the opioid epidemic. Previous studies have investigated the effects of a multitude of patient-specific risk factors on prolonged opioid use postoperatively. However, to date, there is a lack of studies examining the effects of multiple prescribers during the perioperative period and their potential contribution to prolonged opioid use postoperatively. Read More

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Successful robotic proximal gastrectomy with side overlap esophagogastrostomy following preoperative chemotherapy: A case report.

Int J Surg Case Rep 2022 May 14;94:107040. Epub 2022 Apr 14.

Department of Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

Introduction And Importance: Adenocarcinoma of the esophagogastric junction (AEJ) has been on the rise in recent years, but the technical aspects of reconstruction and reflux prevention are unsolved problems. This case report aimed to illustrate the usefulness of preoperative chemotherapy for tumor shrinkage and the advantage of robotic surgery for stable reconstruction with reflux prevention.

Case Presentation: A 69-year-old male patient was diagnosed with AEJ cT3N0M0 cStage IIB. Read More

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Short-term and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer.

Ann Coloproctol 2022 May 25. Epub 2022 May 25.

Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileo-sigmoid or ileo-rectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. Read More

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Migration of Hospital Total Hip and Knee Arthroplasty Procedures to an Ambulatory Surgery Center Setting and Postsurgical Opioid Use: A Private Practice Experience.

Am Health Drug Benefits 2022 Mar;15(1):21-29

Senior Director, Health Outcomes Value Assessment & Analytics, Pacira BioSciences, Parsippany, NJ, when this study was conducted.

Background: An enhanced recovery pathway using individualized multimodal pain management with scheduled nonopioid and opioid regimens previously enabled reproducible same-day discharge of Medicare beneficiaries and commercially insured patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) procedures in the hospital or in ambulatory surgery center settings.

Objective: To analyze the migration trends for TKA and THA procedures from a hospital to an ambulatory surgery center facility and to assess perioperative outcomes before and after incorporating liposomal bupivacaine into a multimodal pain management regimen for these procedures.

Methods: This retrospective medical chart review study included patients undergoing THA or TKA with an enhanced recovery pathway in a hospital or an ambulatory surgery center between 2013 and 2019. Read More

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Effect of sedative premedication with oral midazolam on postanesthesia care unit delirium in older adults: a secondary analysis following an uncontrolled before-after design.

Perioper Med (Lond) 2022 May 19;11(1):18. Epub 2022 May 19.

Department of Anaesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Background: Sedative premedication with benzodiazepines has been linked with prolonged recovery and inadequate emergence during the immediate postoperative period. We aimed to analyze the association between postanesthesia care unit (PACU) delirium and sedative premedication with oral midazolam.

Methods: We performed a secondary analysis of prospectively collected data before (midazolam cohort) and after (non-midazolam cohort) implementation of a restrictive strategy for oral premedication with midazolam. Read More

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Usability of a perioperative medication-related clinical decision support software application: a randomized controlled trial.

J Am Med Inform Assoc 2022 May 16. Epub 2022 May 16.

Harvard Medical School, Boston, Massachusetts, USA.

Objective: We developed a comprehensive, medication-related clinical decision support (CDS) software prototype for use in the operating room. The purpose of this study was to compare the usability of the CDS software to the current standard electronic health record (EHR) medication administration and documentation workflow.

Materials And Methods: The primary outcome was the time taken to complete all simulation tasks. Read More

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Standardizing Perioperative Medications to Be Used in an Enhanced Recovery After Surgery Program Is Feasible in Percutaneous Nephrolithotomy Patients.

J Endourol 2022 Jun 9. Epub 2022 Jun 9.

Department of Urology, University of California San Diego Health, San Diego, California, USA.

The objective of this process improvement project was to determine the effect of enhanced recovery after surgery (ERAS) protocol for percutaneous nephrolithotomy (PCNL) patients with respect to quality of life (QOL) and pain management in the postoperative recovery period. An electronic-based medical record ERAS orders protocol for PCNL was instituted at an academic medical center in July 2020. The protocol utilized a pain control regimen designed to minimize opioid medication use postoperatively. Read More

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Perioperative Management and Long-Term Outcomes in Ocular Cicatricial Pemphigoid Patients Undergoing Cataract Surgery.

Oxid Med Cell Longev 2022 30;2022:2496649. Epub 2022 Apr 30.

Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China.

Objective: To observe the outcomes of cataract surgery in ocular cicatricial pemphigoid (OCP) patients and explore routine perioperative medical treatments.

Design: Retrospective case series.

Methods: Fourteen eyes of 8 patients were included in the study. Read More

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Pain and Analgesic Utilization in Medically Underserved Areas: Five-Year Prevalence Study from the Rochester Epidemiology Project.

J Pain Res 2022 3;15:1297-1304. Epub 2022 May 3.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.

Purpose: There is a paucity of data on pain diagnoses and analgesic utilization in medically underserved areas (MUAs). This study compared the prevalence of pain diagnoses and analgesic medication use between MUAs and non-medically underserved areas (N-MUAs) in Southern Minnesota and Western Wisconsin using the Rochester Epidemiology Project (REP) database.

Methods: Five-year prevalence per 100 people (January 1, 2011 to January 1, 2016) was extracted from the REP database for multiple pain diagnosis variables and analgesic medications. Read More

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Integration of the Codonics Safe Label System and the Omnicell XT Anesthesia Workstation into Pediatric Anesthesia Practice: Utilizing Technology to Increase Medication Labeling Compliance and Decrease Medication Discrepancies While Maintaining User Acceptability.

Hosp Pharm 2022 Feb 6;57(1):11-16. Epub 2020 Nov 6.

Children's Hospital Colorado, Aurora, USA.

Perioperative medication errors are recognized as a source of patient morbidity and mortality. Medication management systems with built-in scanning and label-printing functions that integrate with medication-dispensing cabinets have the potential to decrease medication administration errors by improving compliance with medication labeling. Whether these management systems will also improve periodic automatic replacement (PAR) inventory control and be accepted by users is unknown. Read More

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February 2022

Penicillin allergy SHACK: Survey of hospital and community knowledge.

J Paediatr Child Health 2022 May 3. Epub 2022 May 3.

Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, Western Australia, Australia.

Aim: Penicillin allergy accounts for the majority of all reported adverse drug reactions in adults and children. Foregoing first-line antibiotic therapy due to penicillin allergy label is associated with an increased prevalence of infections by resistant organisms and longer hospitalisation. Clinician awareness of allergy assessment, referral indications, management of allergy and anaphylaxis is therefore vital but globally lacking. Read More

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Perioperative Antithrombotic Management During Gastroenterological Surgery in Patients With Thromboembolic Risks: Current Status and Future Prospects.

Cureus 2022 Mar 24;14(3):e23471. Epub 2022 Mar 24.

Surgery, Kokura Memorial Hospital, Kitakyushu, JPN.

Antiplatelet medicines and anticoagulants are two types of antithrombotic pharmaceuticals, with anticoagulants including warfarin and direct oral anticoagulants (DOACs). During the perioperative phase, patients receiving antithrombotic therapy must balance two risks: bleeding and thromboembolism. To date, there are no defined recommendations for antithrombotic drug management in gastroenterological (GE) surgery, and the management strategy varies greatly between hospitals. Read More

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Early Postoperative Opioid Requirement is Associated With Later Pain Control Needs After Supratentorial Craniotomies.

J Neurosurg Anesthesiol 2022 Apr 15. Epub 2022 Apr 15.

Departments ofNeurosurgery.

Background: Despite a renewed focus in recent years on pain management in the inpatient hospital setting, postoperative pain after elective craniotomy remains under investigated. This study aims to identify which perioperative factors associate most strongly with postoperative pain and opioid medication requirements after inpatient craniotomy.

Materials And Methods: Using an existing dataset, we selected a restricted cohort of patients who underwent elective craniotomy surgery requiring an inpatient postoperative stay during a 7-year period at our institution (n=1832). Read More

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Best Practices for Postoperative Management of Posterior Sacroiliac Joint Fusion.

J Pain Res 2022 19;15:1149-1162. Epub 2022 Apr 19.

Department of Pain Medicine, The Spine and Nerve Center of the Virginias, Charleston, WV, USA.

Sacroiliac joint (SIJ) pain is a common cause of low back pain. Traditionally, treatment for SIJ joint pain and dysfunction has consisted of physical therapy, medication management, SIJ injections, and SIJ ablations. Improved recognition of the SIJ as an etiology for back pain has led to advances in treatment options. Read More

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Evaluation of an emergency safe supply drugs and managed alcohol program in COVID-19 isolation hotel shelters for people experiencing homelessness.

Drug Alcohol Depend 2022 Jun 7;235:109440. Epub 2022 Apr 7.

North End Community Health Centre, Halifax, Nova Scotia, Canada; Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Direction 180, Halifax, Nova Scotia, Canada.

Background: During a COVID-19 outbreak in the congregate shelter system in Halifax, Nova Scotia, Canada, a healthcare team provided an emergency "safe supply" of medications and alcohol to facilitate isolation in COVID-19 hotel shelters for residents who use drugs and/or alcohol. We aimed to evaluate (a) substances and dosages provided, and (b) outcomes of the program.

Methods: We reviewed medical records of all COVID-19 isolation hotel shelter residents during May 2021. Read More

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Short-term administration of oral relugolix before single-port laparoscopic-assisted vaginal hysterectomy for symptomatic uterine myomas: A retrospective comparative study with leuprorelin injection.

Authors:
Akihiro Takeda

J Obstet Gynaecol Res 2022 Apr 23. Epub 2022 Apr 23.

Department of Obstetrics and Gynecology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan.

Aim: To investigate the efficacy of short-term administration of relugolix, a novel orally active gonadotropin-releasing hormone (GnRH) antagonist, before single-port laparoscopic-assisted vaginal hysterectomy (LAVH) for symptomatic uterine myomas, retrospectively compared with injection of leuprorelin, a GnRH agonist.

Methods: A retrospective comparative study of each 35 women with symptomatic myomas in the relugolix and leuprorelin groups.

Results: Before administration of relugolix and leuprorelin, the median uterine volume did not differ significantly between the two groups (p = 0. Read More

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Nicardipine Is a Safe, Efficacious, and Cost-Effective Antihypertensive for Neonates and Young Infants Undergoing Cardiac Surgery.

World J Pediatr Congenit Heart Surg 2022 05;13(3):341-345

Department of Surgery-Cardiothoracic, 5228University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

Objective: The use of nicardipine in congenital cardiac surgery has been guarded given the calcium sensitivity of immature myocardium and paucity of clinical data. Reports of nicardipine use have excluded neonates with single ventricles. The goal of this study was to compare the use of nicardipine and sodium nitroprusside for postoperative blood pressure control in young patients recovering from cardiac surgery. Read More

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An International Survey on the Practice of Lumbar Radiofrequency Ablation for Management of Zygapophyseal (Facet)-Mediated Low Back Pain.

J Pain Res 2022 14;15:1083-1090. Epub 2022 Apr 14.

The Spine and Nerve Centers, Charleston, WV, USA.

Objective: The objective of this study was to survey current clinical practice related to lumbar radiofrequency (RFA) for the treatment of zygapophyseal (facet)-mediated low back pain.

Methods: Survey questions regarding the clinical practice of lumbar RFA were created and piloted by the American Society of Pain and Neuroscience (ASPN) leadership. After revision for clarity, health-care professionals worldwide who hold membership status within the ASPN Society and who offer lumbar RFA in their clinical practice were recruited to participate in this online survey. Read More

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Early postoperative pulmonary complications after minimally invasive esophagectomy in the prone position: incidence and perioperative risk factors from the perspective of anesthetic management.

Gen Thorac Cardiovasc Surg 2022 Jul 18;70(7):659-667. Epub 2022 Apr 18.

Department of Anesthesiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.

Objectives: To investigate the incidence of and the risk factors for early postoperative pulmonary complications (PPC) after minimally invasive esophagectomy (MIE) in the prone position from the perspective of anesthetic management.

Methods: We conducted a historical cohort study of patients who underwent MIE in the prone position between September 2010 and August 2018. PPC was defined as pneumonia, atelectasis, acute respiratory distress syndrome (ARDS), respiratory failure, and pulmonary embolism (Clavien-Dindo Classification Grade II or higher) that occurred within 7 days after MIE. Read More

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Perioperative Satisfaction and Health Economic Questionnaires in Patients Undergoing an Elective Hip and Knee Arthroplasty: A Prospective Observational Cohort Study.

Anesth Essays Res 2021 Oct-Dec;15(4):413-438. Epub 2022 Mar 30.

Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Background: Early hospital discharge shifts the recovery burden toward the patient and can leave patients and their caregivers anxious about the recovery process. Postoperative home care must be broadened to include appropriate and adequate support to address recovery at home. In this prospective study, patient and caregiver perspectives on the level of preparation/satisfaction and cost associated with management of recovery in the postoperative period were evaluated. Read More

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