1,572 results match your criteria Perioperative Medication Management


Implant Placement in Patients under Treatment with Rivaroxaban: A Retrospective Clinical Study.

Int J Environ Res Public Health 2020 Jun 26;17(12). Epub 2020 Jun 26.

Department of Surgical, Medical, Molecular and of Critical Area Pathologies, Complex Operative Unit of Stomatology and Oral Surgery, University-Hospital of Pisa, University of Pisa, 56126 Pisa, Italy.

The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Read More

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http://dx.doi.org/10.3390/ijerph17124607DOI Listing

Perioperative Prescribing Practices of Extended-Release Opioids in Noncancer Surgical Patients, 2015-2018.

Anesth Analg 2020 Jun 15. Epub 2020 Jun 15.

Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, California.

Background: Extended-release (ER) opioids are indicated for the management of persistent moderate to severe pain in patients requiring around-the-clock opioid analgesics for an extended period of time. Concerns have been raised regarding safety of ER opioids due to its potential for abuse and dependence. However, little is known about perioperative prescribing practices of ER opioids. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004952DOI Listing

[ANESTHESIOLOGY AND CRITICAL CARE, PERIOPERATIVE MEDICINE, PAIN MANAGEMENT, EMERGENCY MEDICINE AND RESUSCITATION].

Authors:
Benjamin Drenger

Harefuah 2020 Jun;159(6):406-409

Hebrew University and Hadassah Faculty of Medicine, Jerusalem, Israel.

Introduction: Anesthesia and intensive care, perioperative medicine and pain management, emergency medicine and resuscitation, all together constitute the field of action of the anesthesiologist. The definition of "anesthesiologist" underestimates the profession, and the lack of anesthesiologists seems understandable when we examine the scope of their activities throughout the hospital. There is little awareness among the public of the extent of the anesthesiologist's activity. Read More

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A Novel Application of Ultrasound-Guided Interscalene Anesthesia for Proximal Humeral Fractures.

J Emerg Med 2020 Jun 19. Epub 2020 Jun 19.

Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Division of Emergency Ultrasound, Massachusetts General Hospital, Boston, Massachusetts.

Background: Proximal humeral fractures are commonly encountered in the emergency department (ED). These injuries are often associated with significant pain, with patients often receiving multiple doses of opiate medications while awaiting definitive management. The interscalene nerve block has been efficacious as perioperative analgesia for patients undergoing operative shoulder repair. Read More

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http://dx.doi.org/10.1016/j.jemermed.2020.05.013DOI Listing

Discovery and validation of biomarkers to aid the development of safe and effective pain therapeutics: challenges and opportunities.

Nat Rev Neurol 2020 Jul 15;16(7):381-400. Epub 2020 Jun 15.

Division of Translational Research, National Institute of Neurological Disorders and Stroke, NIH, Rockville, MD, USA.

Pain medication plays an important role in the treatment of acute and chronic pain conditions, but some drugs, opioids in particular, have been overprescribed or prescribed without adequate safeguards, leading to an alarming rise in medication-related overdose deaths. The NIH Helping to End Addiction Long-term (HEAL) Initiative is a trans-agency effort to provide scientific solutions to stem the opioid crisis. One component of the initiative is to support biomarker discovery and rigorous validation in collaboration with industry leaders to accelerate high-quality clinical research into neurotherapeutics and pain. Read More

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http://dx.doi.org/10.1038/s41582-020-0362-2DOI Listing

A Systems Theoretic Process Analysis of the Medication Use Process in the Operating Room.

Anesthesiology 2020 Jun 10. Epub 2020 Jun 10.

From the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital (A.S.-W., K.C.N.) Harvard Medical School (K.C.N.), Boston, Massachusetts.

Background: While 4 to 10% of medications administered in the operating room may involve an error, few investigations have prospectively modeled how these errors might occur. Systems theoretic process analysis is a prospective risk analysis technique that uses systems theory to identify hazards. The purpose of this study was to demonstrate the use of systems theoretic process analysis in a healthcare organization to prospectively identify causal factors for medication errors in the operating room. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003376DOI Listing

Efficacy and mechanisms of a single-session behavioral medicine class among patients with chronic pain taking prescription opioids: study protocol for a randomized controlled trial.

Trials 2020 Jun 12;21(1):521. Epub 2020 Jun 12.

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, 1070 Arastradero Road, Suite 200, Palo Alto, CA, 94304, USA.

Background: Independent of pain intensity, pain-specific distress is highly predictive of pain treatment needs, including the need for prescription opioids. Given the inherently distressing nature of chronic pain, there is a need to equip individuals with pain education and self-regulatory skills that are shown to improve adaptation and improve their response to medical treatments. Brief, targeted behavioral medicine interventions may efficiently address the key individual factors, improve self-regulation in the context of pain, and reduce the need for opioid therapy. Read More

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http://dx.doi.org/10.1186/s13063-020-04415-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290153PMC

Pilot prospective open-label one-arm trial investigating intrathecal Adenosine in neuropathic pain after lumbar discectomy.

BMC Res Notes 2020 Jun 12;13(1):284. Epub 2020 Jun 12.

Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran.

Objectives: Adenosine has an analgesic and anti-inflammatory role and its injections are used for perioperative pain management. We aimed to study efficacy of intrathecal injection of adenosine for post-operative radicular pain after lumbar discectomy. Forty patients with unilevel lumbar discectomy who had radicular lower limb pain were treated by 1000 micrograms of intrathecal injection of adenosine in this single-arm prospective open-label trial between November 2015 to October 2016. Read More

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http://dx.doi.org/10.1186/s13104-020-05133-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291557PMC

A Comparison of Hip Spica Casting to Short Leg Casts and Bar after Hip Reconstruction in Cerebral Palsy.

Cureus 2020 May 8;12(5):e8028. Epub 2020 May 8.

Orthopaedic Surgery, Gillette Children's Specialty Healthcare, Saint Paul, USA.

Background Immobilization after hip reconstruction in children with cerebral palsy varies according to surgeon preference. The effect of postoperative immobilization on postoperative pain is unknown. Success in achieving hip stability and complications may also differ depending on the immobilization technique utilized. Read More

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http://dx.doi.org/10.7759/cureus.8028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282370PMC

Persistent Blood Flow inside the Woven EndoBridge Device More Than 6 Months after Intracranial Aneurysm Treatment: Frequency, Mechanisms, and Management-A Retrospective Single-Center Study.

AJNR Am J Neuroradiol 2020 Jun 11. Epub 2020 Jun 11.

Department of Neuroradiology (H.A.N., S.S., P.-F.M., L.P.), Hôpital Maison-Blanche, Reims, France.

Background And Purpose: Due to its high safety and great efficacy, flow disruption with the Woven EndoBridge (WEB) device is increasingly used to treat intracranial aneurysms. We recently identified patients with intracranial aneurysm treated with the WEB who presented with residual blood flow inside the device ("contrast-in-WEB" phenomenon) more than 6 months posttreatment. This series reports the frequency and underlying mechanisms and discusses management of this phenomenon. Read More

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http://dx.doi.org/10.3174/ajnr.A6593DOI Listing

Narrative Summary of Recently Published Literature on Intravenous Ibuprofen.

Clin Ther 2020 Jun 3. Epub 2020 Jun 3.

Medavera LLC, Springfield, MO, USA. Electronic address:

Purpose: This is a narrative review of the published literature on IV ibuprofen (IVIB) as one of the drugs used in multimodal pain management in inpatients and outpatients pre- and postoperatively and for nonsurgical pain or fever.

Methods: The efficacy, concurrent opioid use, pharmacokinetic properties, tolerability, stress response, and postoperative recovery with IVIB, which were investigated in 9 clinical studies, are presented in this narrative review. In total, 1062 adult patients and healthy volunteers were included in these 9 studies; 757 of these subjects received IVIB, and the remaining 305 received either placebo or a comparator medication. Read More

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http://dx.doi.org/10.1016/j.clinthera.2020.05.004DOI Listing

Diagnosis and Management of Opioid Use Disorder in Hospitalized Patients.

Med Clin North Am 2020 Jul 12;104(4):695-708. Epub 2020 May 12.

Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA.

The diagnosis of opioid use disorder (OUD) is often overlooked or inadequately managed during the inpatient admission. When recognized, a common strategy is opioid detoxification, an approach that is often ineffective and can be potentially dangerous because of loss of tolerance and subsequent risk for overdose. Medication for addiction treatment (MAT), including methadone and buprenorphine, is effective and can be dispensed in the hospital for both opioid withdrawal and initiation of maintenance treatment. Read More

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http://dx.doi.org/10.1016/j.mcna.2020.03.003DOI Listing

Factors Affecting Post-Anesthesia Care Unit Length of Stay in Pediatric Patients after an Adenotonsillectomy.

Ann Otol Rhinol Laryngol 2020 Jun 2:3489420931557. Epub 2020 Jun 2.

Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA.

Objectives: (1) To identify clinical factors and perioperative practices that correlate with longer length of stay (LOS) in the post-anesthesia care unit (PACU) after adenotonsillectomy (T&A) in pediatric populations. (2) To understand the relationship between family presence and PACU LOS for pediatric patients after T&A.

Methods: Pediatric patients (ages 3-17) who underwent T&A between February 2016 and December 2016 were retrospectively reviewed. Read More

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http://dx.doi.org/10.1177/0003489420931557DOI Listing

Using pharmacogenetics to structure individual pain management protocols in total knee arthroplasty.

Bone Joint J 2020 Jun;102-B(6_Supple_A):73-78

Anderson Orthopaedic Research Institute, Alexandria, Virginia, USA.

Aims: The purpose of this study was to use pharmacogenetics to determine the frequency of genetic variants in our total knee arthroplasty (TKA) patients that could affect postoperative pain medications. Pharmacogenetic testing evaluates patient DNA to determine if a drug is expected to have a normal clinical effect, heightened effect, or no effect at all on the patient. It also predicts whether patients are likely to experience side effects from medicine. Read More

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http://dx.doi.org/10.1302/0301-620X.102B6.BJJ-2019-1539.R1DOI Listing

A systematic review of best practices for the perioperative management of abdominal sacrocolpopexy.

Neurourol Urodyn 2020 Jun 29;39(5):1264-1275. Epub 2020 May 29.

Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland.

Purpose: Enhanced recovery after surgery (ERAS) pathways have been shown to reduce surgical morbidity and length of stay across various procedures. Our objective was to systematically evaluate the literature for best practices of ERAS elements in abdominal sacrocolpopexy (ASC), to determine if there is sufficient evidence to create best practice guidelines for this procedure.

Materials And Methods: Following the preferred reporting items for systematic review and meta-analysis (PRISMA) statement, we performed a review using Pubmed, Embase, and Cochrane Library. Read More

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http://dx.doi.org/10.1002/nau.24411DOI Listing

Underutilization of Nonopioid Pain Medication in Patients Undergoing Abdominal Aortic Aneurysm Repair.

Ann Vasc Surg 2020 May 20. Epub 2020 May 20.

Division of Vascular Surgery, NYU Langone Medical Center, New York, NY. Electronic address:

Background: With increased focus on the opioid crisis, it was our goal to describe rates and risk factors for postoperative use of opioids in patients undergoing abdominal aortic aneurysm (AAA) repair as well as identify pain modalities that are underutilized.

Methods: We retrospectively analyzed perioperative analgesic prescriptions for endovascular (EVAR) and open AAA repair between January 1, 2010 and January 1, 2018. Patients' baseline opioid use, demographics, and medical comorbidities were obtained. Read More

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http://dx.doi.org/10.1016/j.avsg.2020.04.068DOI Listing

Perioperative anesthesia care for patients with confirmed or suspected COVID-19.

Cleve Clin J Med 2020 May 20. Epub 2020 May 20.

Anesthesiology Institute, Cleveland Clinic.

The operating room environment is very dynamic with many unique challenges for anesthesia teams caring for patients with confirmed or suspected COVID-19. Specific recommendations by national organizations and institution specific step-by-step guidelines and education materials are required to maintain safety for both patients and caregivers perioperatively, with transport, and medication management. Read More

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http://dx.doi.org/10.3949/ccjm.87a.ccc035DOI Listing

Marginal ulceration following Roux-en-Y gastric bypass: risk factors for ulcer development, recurrence and need for revisional surgery.

Surg Endosc 2020 May 18. Epub 2020 May 18.

Division of General Surgery, University Health Network, Toronto, ON, Canada.

Background: Marginal ulcer formation is a known complication following RYGB. While most respond to medical therapy, many patients have recurrent or chronic MU. Although non-steroidal anti-inflammatory drug (NSAID) use, smoking and Helicobacter pylori infection are known risk factors of MU, little is known about what increases the likelihood of developing recalcitrant ulcers. Read More

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http://dx.doi.org/10.1007/s00464-020-07650-0DOI Listing

Surviving Case of a Blowout-Type Left Ventricular Free Wall Rupture During Percutaneous Coronary Intervention for a Lateral Acute Myocardial Infarction.

Int Heart J 2020 May 15;61(3):606-610. Epub 2020 May 15.

Division of Cardiology, Department of Medicine, Nihon University School of Medicine.

A 76-year-old man suffering from chest pain was admitted to our hospital with a suspected acute myocardial infarction (AMI). Emergent coronary angiography revealed a totally occluded proximal left circumflex artery (LCX). During primary percutaneous coronary intervention, his blood pressure suddenly fell within seconds, and he developed pulseless electrical activity (PEA). Read More

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http://dx.doi.org/10.1536/ihj.19-495DOI Listing

Development of an application for management of drug holidays in perioperative periods.

Medicine (Baltimore) 2020 May;99(19):e20142

Safety Management Section, Saga University Hospital.

Before surgery and other invasive treatments, decisions must be made on whether to discontinue drugs and provide appropriate drug holidays especially for antithrombotic drugs, and this is made difficult by the large number of available drugs and associated guidelines. We have therefore developed an online application for perioperative drug discontinuation and resumption management, named Saga Application for Management of Drug Holidays in PeriOperative Periods (SAMPOP).Multidisciplinary medical staff at Saga University Hospital (SUH) worked together to build an evidence-based Perioperative Drug Discontinuation Management Database (PDDMD) and developed the user-friendly SAMPOP online application via preliminary verification at SUH. Read More

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http://dx.doi.org/10.1097/MD.0000000000020142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220215PMC

Prehospital acute traumatic pain assessment and management practices in the Western Cape, South Africa: a retrospective review.

Int J Emerg Med 2020 May 5;13(1):21. Epub 2020 May 5.

Division of Emergency Medicine, University of Cape Town (UCT), Cape Town, South Africa.

Background: Trauma is a common aetiology of acute pain in the emergency setting, and traumatic injuries have been recognised as a global public health crisis leading to numerous deaths and disabilities. This study aimed to identify the prevalence of acute pain among high acuity trauma patients presenting to a public sector emergency medical service and to describe prehospital acute traumatic pain assessment and management practices amongst emergency care providers in the Western Cape Province, South Africa.

Methods: A retrospective review of electronic patient care reports of trauma patients treated by the South African Western Cape Emergency Medical Services between January 1 and December 31, 2017 was conducted. Read More

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http://dx.doi.org/10.1186/s12245-020-00278-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201999PMC

Emergency surgery during the COVID-19 pandemic: what you need to know for practice.

Ann R Coll Surg Engl 2020 May 30;102(5):323-332. Epub 2020 Apr 30.

University Hospital of Parma, Italy.

Introduction: Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic.

Methods: A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. Read More

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http://dx.doi.org/10.1308/rcsann.2020.0097DOI Listing

Anesthesia and COVID-19: What We Should Know and What We Should Do.

Semin Cardiothorac Vasc Anesth 2020 Jun 27;24(2):127-137. Epub 2020 Apr 27.

Harvard Medical School, Boston, MA, USA.

Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), was first reported in Wuhan, Hubei, China, and has spread to more than 200 other countries around the world. COVID-19 is a highly contagious disease with continuous human-to-human transmission. The origin of the virus is unknown. Read More

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http://dx.doi.org/10.1177/1089253220921590DOI Listing

Head and neck oncology during the COVID-19 pandemic: Reconsidering traditional treatment paradigms in light of new surgical and other multilevel risks.

Oral Oncol 2020 06 6;105:104684. Epub 2020 Apr 6.

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States.

The COVID-19 pandemic demands reassessment of head and neck oncology treatment paradigms. Head and neck cancer (HNC) patients are generally at high-risk for COVID-19 infection and severe adverse outcomes. Further, there are new, multilevel COVID-19-specific risks to patients, surgeons, health care workers (HCWs), institutions and society. Read More

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http://dx.doi.org/10.1016/j.oraloncology.2020.104684DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136871PMC

Process Mining and Ethnography Study of Medication Reconciliation Tasks.

AMIA Annu Symp Proc 2019 4;2019:1167-1176. Epub 2020 Mar 4.

College of Medicine, Mayo Clinic, Rochester, MN, US.

We studied the medication reconciliation (MedRec) task through analysis of computer logs and ethnographic data. Time spent by healthcare providers performing MedRec was compared between two different EHR systems used at four different regional perioperative settings. Only one of the EHRs used at two settings generated computer logs that supported automatic discovery of the MedRec task. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153070PMC

Retention and Migration of Rwandan Anesthesiologists: A Qualitative Study.

Anesth Analg 2020 Apr 16. Epub 2020 Apr 16.

Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Background: Health care professional migration continues to challenge countries where the lack of surgical and anesthesia specialists results in being unable to address the global burden of surgical disease in their populations. Medical migration is particularly damaging to health care systems that are just beginning to scale up capacity building of human resources for health. Anesthesiologists are scarce in low-resource settings. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004794DOI Listing
April 2020
3.472 Impact Factor

Effect of scheduled intravenous acetaminophen on postoperative nausea and vomiting in patients undergoing laparoscopic gynecologic surgery.

J Anesth 2020 Apr 17. Epub 2020 Apr 17.

Department of Anesthesiology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa, Japan.

Purpose: The aim of this study was to assess the effect of scheduled intravenous acetaminophen (SIVA) on the incidence of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecologic surgery (LGS).

Methods: This retrospective observational study identified consecutive patients who underwent LGS at our institution from January to November of 2017 and were managed with either our hospital's old protocol (Group H) or a new protocol using SIVA (Group S). Primary outcomes included the incidences of PONV and the amount of additional antiemetic required in the postoperative period. Read More

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http://dx.doi.org/10.1007/s00540-020-02777-9DOI Listing

Additional periarticular catheter shows no superiority over single-shot local infiltration analgesia alone in unicondylar knee replacement.

Knee Surg Sports Traumatol Arthrosc 2020 Apr 17. Epub 2020 Apr 17.

Sportklinik Stuttgart, Taubenheimstraße 8, 70372, Stuttgart, Germany.

Purpose: Local infiltration analgesia (LIA) has attracted growing interest in recent years. To prolong the positive effects of LIA, a continuous intraarticular perfusion has been introduced in total knee arthroplasty with good clinical results. The purpose of the present study was to evaluate if similar results can be obtained with the use of a continuous periarticular perfusion in unicondylar knee arthroplasty (UKA). Read More

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http://dx.doi.org/10.1007/s00167-020-05981-yDOI Listing

Chinese Expert Consensus on Perioperative Medication in Laser Corneal Refractive Surgeries (2019).

Authors:
Ying Li Yan Wang

Chin Med Sci J 2020 Mar;35(1):1-12

Tianjin Eye Hospital, Nankai University Eye Hospital, Tianjin 300020, China.

Laser corneal refractive surgery has become an important treatment to correct ametropia in recent years. Rational medication in the perioperative period is essential to ensure the success of the surgery and to reduce complications. However, in this area there has been no consistent understanding and unified application guide across the world. Read More

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http://dx.doi.org/10.24920/003712DOI Listing

Medical management after subthalamic stimulation in Parkinson's disease: a phenotype perspective.

Arq Neuropsiquiatr 2020 Apr;78(4):230-237

Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Centro de Distúrbios do Movimento, São Paulo SP, Brazil.

Subthalamic nucleus deep brain stimulation (STN DBS) is an established treatment that improves motor fluctuations, dyskinesia, and tremor in Parkinson's disease (PD). After the surgery, a careful electrode programming strategy and medical management are crucial, because an imbalance between them can compromise the quality of life over time. Clinical management is not straightforward and depends on several perioperative motor and non-motor symptoms. Read More

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http://dx.doi.org/10.1590/0004-282X20190188DOI Listing

Anesthesia for bilateral pulmonary banding as part of hybrid stage I approach palliating neonates with hypoplastic left heart syndrome.

Paediatr Anaesth 2020 Apr 14. Epub 2020 Apr 14.

Paediatric Cardiac Anesthesiology Service, Pediatric Heart Centre, Department of Anaesthesiology Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg GmbH, Giessen, Germany.

Background: Neonatal management of patients with hypoplastic left heart syndrome and complex remains a challenging task, whereby the "hybrid" palliation is often reserved for high-risk patients as a "rescue" procedure.

Aim: This study documents the anesthetic challenges and potential complications associated with the Giessen hybrid stage I approach.

Methods: The Giessen hybrid stage I approach is focused on surgical bilateral pulmonary artery banding. Read More

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http://dx.doi.org/10.1111/pan.13876DOI Listing

Forecasting a Crisis: Machine-Learning Models Predict Occurrence of Intraoperative Bradycardia Associated With Hypotension.

Anesth Analg 2020 05;130(5):1201-1210

From the Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington.

Background: Predictive analytics systems may improve perioperative care by enhancing preparation for, recognition of, and response to high-risk clinical events. Bradycardia is a fairly common and unpredictable clinical event with many causes; it may be benign or become associated with hypotension requiring aggressive treatment. Our aim was to build models to predict the occurrence of clinically significant intraoperative bradycardia at 3 time points during an operative course by utilizing available preoperative electronic medical record and intraoperative anesthesia information management system data. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004636DOI Listing

Efficacy of vonoprazan for the prevention of bleeding after gastric endoscopic submucosal dissection with continuous use of antiplatelet agents.

Endosc Int Open 2020 Apr 23;8(4):E481-E487. Epub 2020 Mar 23.

Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan.

 Post-procedural bleeding, after gastric endoscopic submucosal dissection (ESD) for high risk thromboembolic cases that require continuous antiplatelet therapy, is challenging. Its incidence rate is > 20 % among those using conventional antacids. We evaluated the efficacy of perioperative management with vonoprazan to prevent post-ESD bleeding. Read More

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http://dx.doi.org/10.1055/a-1067-4380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089797PMC

A Qualitative Study of Perioperative Depression and Anxiety in Older Adults.

Am J Geriatr Psychiatry 2020 Mar 2. Epub 2020 Mar 2.

Department Anesthesiology of (JA, AM, TK, MSA), School of Medicine, Washington University, St. Louis, MO.

Objective: We had three aims 1) understand barriers to perioperative management of anxiety and depression in older surgical patients; 2) identify preferences and requirements for interventions to manage their anxiety and depression; and 3) explore the feasibility of implementing such interventions in perioperative care.

Design: A qualitative study using semistructured interviews was conducted.

Setting: Participants were recruited at a large academic medical center. Read More

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http://dx.doi.org/10.1016/j.jagp.2020.02.010DOI Listing

The Standardization of Outpatient Procedure (STOP) Narcotics after anorectal surgery: a prospective non-inferiority study to reduce opioid use.

Tech Coloproctol 2020 06 30;24(6):563-571. Epub 2020 Mar 30.

Division of General Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Background: Prescription of opioid medication after ambulatory anorectal surgery may be excessive and lead to opioid misuse. The purpose of this study was to evaluate the efficacy of a multi-modality opioid-sparing approach to control postoperative pain and reduce opioid prescriptions after outpatient anorectal surgery.

Methods: A prospective non-inferiority pre- and post-intervention study was completed at three academic hospitals. Read More

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http://dx.doi.org/10.1007/s10151-020-02190-0DOI Listing

Perioperative Management of a Patient Taking Suboxone® at the Time of Ambulatory Surgery.

Case Rep Anesthesiol 2020 9;2020:5628348. Epub 2020 Mar 9.

Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.

In 2016, more than 11 million people reported misuse of opioids in the previous year. In an effort to combat opioid use disorder (OUD), the use of agonist/antagonist is becoming increasingly common, with more than 2.2 million patients reporting use of a buprenorphine containing medication such as Suboxone®. Read More

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http://dx.doi.org/10.1155/2020/5628348DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085354PMC

Matched Pairs Comparison of an Enhanced Recovery Pathway Versus Conventional Management on Opioid Exposure and Pain Control in Patients Undergoing Lung Surgery.

Ann Surg 2020 Mar 30. Epub 2020 Mar 30.

Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX.

Objective: The aim of this study was to assess the effect of an enhanced recovery after surgery (ERAS) pathway on pain and opioid use following lung resection.

Summary Background Data: A major component ERAS pathways is opioid-sparing analgesia; however, the effect on postoperative pain and opioid use in patients undergoing lung resection is unknown.

Methods: Following implementation of an ERAS pathway for lung resection, 123 consecutive patients were identified. Read More

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http://dx.doi.org/10.1097/SLA.0000000000003587DOI Listing

The Management of Perioperative Immunosuppressant Medications for Rheumatoid Arthritis During Elective Hand Surgery.

J Hand Surg Am 2020 Mar 21. Epub 2020 Mar 21.

Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address:

Purpose: Rheumatoid arthritis (RA) is a destructive inflammatory disease that commonly involves joints of the hand and wrist. Different recommendations exist for continuing or discontinuing immunosuppressant medications during the perioperative time period. The purpose of our study was to determine whether continuing or discontinuing medications (steroids, nonbiological, and/or biological disease-modifying antirheumatic drugs [DMARDs]) were associated with an increased or decreased risk of postoperative complications. Read More

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http://dx.doi.org/10.1016/j.jhsa.2020.02.005DOI Listing

Impact of preoperative opioid use on health outcomes after bariatric surgery.

Surg Obes Relat Dis 2020 Jun 20;16(6):768-776. Epub 2020 Feb 20.

University Health Network, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address:

Background: Opioid consumption in North America has risen to alarming levels and represents a potentially modifiable risk factor in perioperative management. Chronic pain and obesity are commonly associated and bariatric surgery remains the most effective intervention for weight loss in morbidly obese patients.

Objectives: To understand how preoperative opioid use impacts surgical outcomes in patients undergoing bariatric surgery. Read More

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http://dx.doi.org/10.1016/j.soard.2020.02.008DOI Listing

[Effects of caudal block in pediatric surgical patients: a randomized clinical trial].

Rev Bras Anestesiol 2020 Feb 20. Epub 2020 Feb 20.

University of Novi Sad, Medical Faculty, Department of Anesthesia and Perioperative Medicine, Novi Sad, República da Sérvia; Institute for the Healthcare of Children and Youth of Vojvodina, Clinic of Pediatric surgery, Department for Pediatric Anesthesia, Intensive Care and Pain Therapy, Novi Sad, República da Sérvia.

Background: Surgery generates a neuroendocrine stress response, resulting in undesirable hemodynamic instability, alterations in metabolic response and malfunctioning of the immune system.

Objectives: The aim of this research was to determine the effectiveness of caudal blocks in intra- and postoperative pain management and in reducing the stress response in children during the same periods.

Methods: This prospective, randomized clinical trial included 60 patients scheduled for elective herniorrhaphy. Read More

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http://dx.doi.org/10.1016/j.bjan.2019.12.003DOI Listing
February 2020

Outpatient narcotic consumption following total shoulder arthroplasty.

JSES Int 2020 Mar 16;4(1):100-104. Epub 2020 Jan 16.

Department of Orthopaedic Surgery, Washington University in St Louis, St Louis, MO, USA.

Introduction: In the setting of the opioid epidemic, physicians continue to scrutinize ways to minimize exposure to narcotic medications. Several studies emphasize improvements in perioperative pain management following total shoulder arthroplasty (TSA). However, there is a paucity of literature describing outpatient narcotic consumption requirements following TSA. Read More

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http://dx.doi.org/10.1016/j.jses.2019.11.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075762PMC

Integrating a pharmacist into the perioperative setting.

Aust Health Rev 2020 Mar 20. Epub 2020 Mar 20.

This paper describes the integration of a pharmacist into a perioperative environment and the ensuing quality and economic benefits. Deficiencies were identified in medication management in operating theatres (OT) at a large tertiary hospital. A perioperative pharmacist was employed for a 6-month pilot period, with permanent funding dependent on demonstration of agreed economic benefits. Read More

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http://dx.doi.org/10.1071/AH19126DOI Listing

[The effects of cannabis and cannabinoids on anesthesia and analgesia during the perioperative period].

Authors:
B Kraft W Stromer

Schmerz 2020 Mar 3. Epub 2020 Mar 3.

Abteilung für Anästhesiologie und Intensivmedizin, Landeskrankenhaus Horn, Spitalgasse 10, 3580, Horn, Österreich.

Cannabis is the most frequently used recreational drug worldwide. Moreover, the use of cannabinoids for medical purposes is also constantly growing and medical cannabis products are legalised by an increasing number of countries. First clinical reports have shown enhanced requirements for propofol and analgesics used for general anesthesia and perioperative pain management in cannabis users. Read More

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http://dx.doi.org/10.1007/s00482-020-00449-xDOI Listing

Quantifying the Crisis: Opioid-Related Adverse Events in Outpatient Ambulatory Plastic Surgery.

Plast Reconstr Surg 2020 03;145(3):687-695

Boston, Mass.; Gurnee, Ill.; Voorhees and Vineland, N.J.; and New York, N.Y. From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School; the American Association for Accreditation of Ambulatory Surgery Facilities; Gary M. Brownstein, M.D., P.C. (private practice); The Reed Center (private practice); and the Plastic and Cosmetic Surgery Institute (private practice).

Background: The United States is currently in the midst of an opioid epidemic precipitated, in part, by the excessive outpatient supply of opioid pain medications. Accordingly, this epidemic has necessitated evaluation of practice and prescription patterns among surgical specialties. The purpose of this study was to quantify opioid-related adverse events in ambulatory plastic surgery. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006570DOI Listing
March 2020
2.993 Impact Factor

Minimally Invasive Lumbar Decompression and Interspinous Process Device for the Management of Symptomatic Lumbar Spinal Stenosis: a Literature Review.

Curr Pain Headache Rep 2020 Feb 18;24(4):13. Epub 2020 Feb 18.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.

Purpose Of Review: Symptomatic lumbar spinal stenosis (LSS) is a condition affecting a growing number of individuals resulting in significant disability and pain. Traditionally, treatment options have consisted of conservative measures such as physical therapy, medication management, epidural injections and percutaneous adhesiolysis, or surgery. There exists a treatment gap for patients failing conservative measures who are not candidates for surgery. Read More

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http://dx.doi.org/10.1007/s11916-020-0845-2DOI Listing
February 2020

Continent cutaneous ileocecal cystoplasty in the treatment of refractory bladder neck contracture and urinary incontinence after prostate cancer treatment.

Can J Urol 2020 Feb;27(1):10093-10098

Department of Surgery, Division of Urology and Urologic Oncology, City of Hope National Medical Center, Duarte, California, USA.

Introduction: To assess the use, complications, and outcomes of continent cutaneous ileocecal cystoplasty (CCIC) for the management of refractory bladder neck contractures and/or urinary incontinence after prostate cancer therapy.

Materials And Methods: An institutional review board approved database was reviewed for patients who underwent CCIC from January 1, 2003 to December 31, 2018. Preoperative, perioperative and postoperative factors were assessed, including complications and outcomes. Read More

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February 2020

Anesthetic management of catheter-based patent ductus arteriosus closure in neonates weighing <3 kg: A Retrospective Observational Study.

Paediatr Anaesth 2020 04 24;30(4):506-510. Epub 2020 Feb 24.

Department of Anesthesiology, University of Texas Health Science Center at Houston, Houston, Texas.

Background: The patent ductus arteriosus is a cardiac lesion commonly found in premature neonates. Though surgical closure via thoracotomy is the most definitive treatment option, it is associated with significant morbidity. New catheter-based closure options offer a potentially safer alternative treatment, even in premature neonates. Read More

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http://dx.doi.org/10.1111/pan.13838DOI Listing

Pharmacogenomics of Pain Management: The Impact of Specific Biological Polymorphisms on Drugs and Metabolism.

Curr Oncol Rep 2020 Feb 6;22(2):18. Epub 2020 Feb 6.

Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA, 71103, USA.

Purpose Of Review: Pain is multifactorial and complex, often with a genetic component. Pharmacogenomics is a relative new field, which allows for the development of a truly unique and personalized therapeutic approach in the treatment of pain.

Recent Findings: Until recently, drug mechanisms in humans were determined by testing that drug in a population and calculating response averages. Read More

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http://dx.doi.org/10.1007/s11912-020-0865-4DOI Listing
February 2020

Multimodal pain control in adolescent posterior spinal fusion patients: a double-blind, randomized controlled trial to validate the effect of gabapentin on postoperative pain control, opioid use, and patient satisfaction.

Spine Deform 2020 Apr 5;8(2):177-185. Epub 2020 Feb 5.

Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, OP31, Portland, OR, 97239-3098, USA.

Study Design: Prospective double-blind, randomized controlled trial.

Objectives: The objective of this study was to validate the efficacy of gabapentin as part of a multimodal pain regimen in a double-blind, randomized controlled trial for patients aged 10-19 years with idiopathic scoliosis undergoing posterior spinal fusion. Perioperative pain management represents a challenge for patients undergoing surgical correction of adolescent spinal deformity. Read More

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http://dx.doi.org/10.1007/s43390-020-00038-zDOI Listing

[Perioperative fluid management].

Chirurg 2020 Feb;91(2):121-127

Universitätsklinik für Allgemein- und Viszeralchirurgie, Klinikum Oldenburg, Rahel-Strauss-Straße 10, 26133, Oldenburg, Deutschland.

An appropriate perioperative infusion management is pivotal for the perioperative outcome of the patient. Optimization of the perioperative fluid treatment often results in enhanced postoperative outcome, reduced perioperative complications and shortened hospitalization. Hypovolemia as well as hypervolemia can lead to an increased rate of perioperative complications. Read More

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http://dx.doi.org/10.1007/s00104-020-01134-6DOI Listing
February 2020