1,336 results match your criteria Perioperative Medication Management


Blood management in hip fractures; are we leaving it too late? A retrospective observational study.

BMC Geriatr 2019 Mar 12;19(1):79. Epub 2019 Mar 12.

School of Health and Sports Science, University of the Sunshine Coast, Sippy Downs, Queensland, 4556, Australia.

Background: Anaemia in hip fracture patients has been associated with increased risk of allogenic blood transfusion (ABT), poorer functional outcomes and increased mortality. Few studies have reported the prevalence of anaemia on admission or its progression prior to surgery in this cohort. We aimed to measure the prevalence of anaemia on admission in older persons who sustain a hip fracture, identify if anaemia develops or progresses prior to surgery, and to report associations with outcome. Read More

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http://dx.doi.org/10.1186/s12877-019-1099-xDOI Listing

Anaphylactic risk due to systemic mastocytosis: Perioperative management in cardiac surgery.

Rev Esp Anestesiol Reanim 2019 Mar 5. Epub 2019 Mar 5.

Servicio de Anestesiología y Reanimación, Hospital Universitario de La Princesa, Madrid, España.

Mastocytosis is a disease characterised by an abnormal proliferation of mast cells. The degranulation of mast cells can be triggered by chemical, physical, and psychological factors, and in severe cases may be accompanied by cardiovascular alterations and shock. Tryptase concentrations greater than 20ug/L may be associated with an increased risk of mastocyte degranulation. Read More

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http://dx.doi.org/10.1016/j.redar.2019.01.008DOI Listing
March 2019
2 Reads

Should we include monitors to improve assessment of awareness and pain in unconscious palliatively sedated patients? A case report.

Palliat Med 2019 Mar 7:269216319835149. Epub 2019 Mar 7.

1 Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Jette, Belgium.

Background:: Awareness and pain during palliative sedation is typically assessed by observational scales, but the use of such scales has been put into question.

Case Presentation:: A woman in her mid-80s was admitted to a palliative care unit, presenting with chronic lymphatic leukemia, depression, and a cerebrovascular accident, with right-sided hemiplegia and aphasia. The patient was unable to eat and was suffering from nausea and vomiting. Read More

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http://dx.doi.org/10.1177/0269216319835149DOI Listing
March 2019
1 Read

Clinical significance of periosteal reaction as a predictive factor for treatment outcome of medication-related osteonecrosis of the jaw.

J Bone Miner Metab 2019 Mar 4. Epub 2019 Mar 4.

Department of Otolaryngology Head and Neck Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan.

Regarding treatment strategies for medication-related osteonecrosis of the jaw (MRONJ), surgical therapy has recently been reported to be more effective than conservative therapy. However, some patients did not achieve complete healing, even when extensive surgery was performed. Periosteal reaction in MRONJ patients is often observed by the CT examination. Read More

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http://dx.doi.org/10.1007/s00774-019-00994-1DOI Listing
March 2019
1 Read

Negative Patient-Experience Comments After Total Shoulder Arthroplasty.

J Bone Joint Surg Am 2019 Feb;101(4):330-337

Department of Orthopaedic Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, Massachusetts.

Background: There is growing interest in enhancing the patient experience after discretionary orthopaedic surgery. Patient narratives are a potentially valuable but largely unscrutinized source of information. Using machine learning to understand sentiment within patient-experience comments, we explored the content of negative comments after total shoulder arthroplasty (TSA), their associated factors, and their relationship with traditional measures of patient satisfaction and with perioperative outcomes. Read More

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http://dx.doi.org/10.2106/JBJS.18.00695DOI Listing
February 2019
1 Read

Clinical Practice Guideline: Tonsillectomy in Children (Update).

Otolaryngol Head Neck Surg 2019 Feb;160(1_suppl):S1-S42

15 Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA.

Objective: This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children <15 years of age based on the most recent published data. Read More

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http://dx.doi.org/10.1177/0194599818801757DOI Listing
February 2019
2 Reads

Perioperative Considerations in the Management of Anticoagulation Therapy for Patients Undergoing Surgery.

Curr Pain Headache Rep 2019 Feb 22;23(2):13. Epub 2019 Feb 22.

Department of Anesthesiology, Yale University School of Medicine, TMP3 333, Cedar Street, New Haven, CT, USA.

Purpose Of Review: As ambulatory surgery has become increasingly more common, the appropriate management of anticoagulation therapy in patients undergoing invasive procedures has become progressively more relevant to healthcare professionals. The purpose of this literature review is to provide an overview of current common anaticoagulants and their pharmacological properties and to evaluate recent relevant literature and bridging therapy and provide recommendations on risk-guided therapy.

Recent Findings: With the development of new drugs and the advancing study and practice of anticoagulation use, clinicians must keep up-to-date on the optimal management of patients requiring anticoagulation. Read More

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http://link.springer.com/10.1007/s11916-019-0747-3
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http://dx.doi.org/10.1007/s11916-019-0747-3DOI Listing
February 2019
4 Reads

Anesthesia considerations and post-operative pain management in pregnant women with chronic opioid use.

Semin Perinatol 2019 Jan 14. Epub 2019 Jan 14.

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

The prevalence of opioid use disorder in pregnancy has escalated markedly in recent years. Chronic opioid use during pregnancy poses several challenges for providing adequate analgesia and anesthesia in the peripartum period. These challenges include the potential for withdrawal, opioid tolerance and opioid-induced hyperalgesia. Read More

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http://dx.doi.org/10.1053/j.semperi.2019.01.004DOI Listing
January 2019
1 Read

Patient preferences for rheumatoid arthritis treatment.

Curr Opin Rheumatol 2019 Feb 11. Epub 2019 Feb 11.

Yale University School of Medicine, New Haven.

Purpose Of Review: To provide an overview of recent articles discussing patient preferences for rheumatoid arthritis (RA) treatment.

Recent Findings: Recent studies examined patient preferences for RA treatment in several populations, finding that most participants were willing to accept certain risks of adverse effects to gain potential benefits. Perspectives regarding cannabis were studied, with patients describing medical marijuana as an alternative therapy to be used with prescription medications or as means of tapering off these medications. Read More

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http://dx.doi.org/10.1097/BOR.0000000000000591DOI Listing
February 2019
3 Reads

Pain and analgesia in pet rabbits within the veterinary environment: a review.

Vet Anaesth Analg 2019 Mar 14;46(2):151-162. Epub 2018 Dec 14.

School of Veterinary Sciences, University of Bristol, Langford, UK.

Objective: To provide an overview of pain and analgesia in rabbits with the aim of developing a more accurate understanding of these topics. To illustrate and discuss the areas that have advanced in recent years and those that still require further research.

Databases Used: Three key subject resources were used: Web of Science, Medline and CAB Abstracts. Read More

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http://dx.doi.org/10.1016/j.vaa.2018.10.007DOI Listing
March 2019
2 Reads

New 5-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures.

J Orthop Trauma 2019 Jan 30. Epub 2019 Jan 30.

Medical University of South Carolina Department of Orthopaedics 96 Jonathan Lucas Dr CSB 708 Charleston, SC 29425.

Introduction: While the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures.

Methods: The NSQIP database was queried for patients aged 60 years and older who underwent surgical management for hip fractures between 2005-2016. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001455DOI Listing
January 2019
1 Read

Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III.

ERJ Open Res 2019 Feb 1;5(1). Epub 2019 Feb 1.

Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK.

Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. Read More

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http://dx.doi.org/10.1183/23120541.00073-2018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355980PMC
February 2019
5 Reads

Effect of restrictive fluid therapy with hydroxyethyl starch during esophagectomy on postoperative outcomes: a retrospective cohort study.

BMC Surg 2019 Feb 4;19(1):15. Epub 2019 Feb 4.

Department of Anesthesiology and Pain Medicine, Laboratory for Perioperative Outcomes Analysis and Research, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.

Background: To improve prognosis after esophageal surgery, intraoperative fluid optimization is important. Herein, we hypothesized that hydroxyethyl starch administration during esophagectomy reduce the total amount of fluid infused and it could have a positive effect on postoperative complication occurrence and mortality.

Methods: All consecutive adult patients who underwent elective esophageal surgery for cancer were studied. Read More

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http://dx.doi.org/10.1186/s12893-019-0482-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360773PMC
February 2019
1 Read

The prevention of infection: 12 modifiable risk factors.

Bone Joint J 2019 01;101-B(1_Supple_A):3-9

Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA and OrthoCarolina Hip and Knee Center, Charlotte, North Carolina, USA.

Aims: Prosthetic joint infection (PJI) remains a serious complication that is associated with high morbidity and costs. The aim of this study was to prepare a systematic review to examine patient-related and perioperative risk factors that can be modified in an attempt to reduce the rate of PJI.

Materials And Methods: A search of PubMed and MEDLINE was conducted for articles published between January 1990 and February 2018 with a combination of search terms to identify studies that dealt with modifiable risk factors for reducing the rate of PJI. Read More

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https://online.boneandjoint.org.uk/doi/10.1302/0301-620X.101
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http://dx.doi.org/10.1302/0301-620X.101B1.BJJ-2018-0233.R1DOI Listing
January 2019
5 Reads

Ultrarestrictive Opioid Prescription Protocol for Pain Management After Gynecologic and Abdominal Surgery.

JAMA Netw Open 2018 Dec 7;1(8):e185452. Epub 2018 Dec 7.

Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.

Importance: Opioids are routinely prescribed for postoperative home pain management for most patients in the United States, with limited evidence of the amount needed to be dispensed. Opioid-based treatment often adversely affects recovery. Prescribed opioids increase the risk of chronic opioid use, abuse, and diversion and contribute to the current opioid epidemic. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2018.5452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324564PMC
December 2018
2 Reads

Interfascial block at the serratus muscle plane versus conventional analgesia in breast surgery: a randomized controlled trial.

Reg Anesth Pain Med 2019 Jan;44(1):52-58

Department of Anesthesiology and Pain Medicine, Hospital de Manises, Valencia, Spain.

Background And Objectives: In the context of opioid-sparing perioperative management, there is still little evidence from randomized controlled trials regarding the effectiveness of interfascial thoracic blocks. This study hypothesizes that receiving a serratus plane block reduces opioid requirements, pain scores, and rescue medication needs.

Methods: This double-blind, randomized controlled study was conducted on 60 adult females undergoing oncologic breast surgery. Read More

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http://dx.doi.org/10.1136/rapm-2018-000004DOI Listing
January 2019
2 Reads

Risk Factors for Recurrent Hematoma After Surgery for Acute Traumatic Subdural Hematoma.

World Neurosurg 2019 Jan 10. Epub 2019 Jan 10.

Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital and University of Turku, Turku, Finland; Neurovascular Surgery Program, Section of Neurosurgery, University of Chicago Medicine and Biological Sciences, Chicago, Illinois, USA. Electronic address:

Objective: The development of postcraniotomy hematoma (PCH) after surgery for acute traumatic subdural hematoma (aSDH) has been associated with an increased risk of a poor outcome. The risk factors contributing to PCH remain poorly understood. Our aim was to study the potential risk factors for PCH in a consecutive series of surgically evacuated patients with aSDH. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S18788750193002
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http://dx.doi.org/10.1016/j.wneu.2018.12.155DOI Listing
January 2019
3 Reads

Increasing compliance of safe medication administration in pediatric anesthesia by use of a standardized checklist.

Paediatr Anaesth 2019 Mar;29(3):258-264

Department of Pediatric Anesthesiology, Cincinnati Children's Hospital, Cincinnati, Ohio.

Background: Medication errors pose a significant risk perioperatively. In the perioperative environment, common medication administration processes are not typically performed. Given the common administration of potentially harmful medications and the potential for medication errors, patient risk is substantial. Read More

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http://doi.wiley.com/10.1111/pan.13578
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http://dx.doi.org/10.1111/pan.13578DOI Listing
March 2019
4 Reads

Physicians' and Nurses' Attitudes and Actions Regarding Perioperative Medication Management.

J Perianesth Nurs 2018 Dec 29. Epub 2018 Dec 29.

Purpose: To investigate physicians' and nurses' attitudes and actions related to the prescription and administration of perioperative antibiotics and opioids during a 2-week period.

Design: A quantitative descriptive and analytical research design performed at a Danish University Hospital.

Methods: An email survey using an 18-item questionnaire was sent to 163 nurses and physicians involved in the perioperative period. Read More

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http://dx.doi.org/10.1016/j.jopan.2018.08.005DOI Listing
December 2018
9 Reads

Perioperative Analgesia for Patients Undergoing Septoplasty and Rhinoplasty: An Evidence-Based Review.

Laryngoscope 2018 Dec 25. Epub 2018 Dec 25.

Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey.

Objectives/hypothesis: Opioid misuse and diversion is a pressing topic in today's healthcare environment. The objective of this study was to conduct a review of non-opioid perioperative analgesic regimens following septoplasty, rhinoplasty, and septorhinoplasty.

Study Design: Evidence-based systematic review. Read More

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http://dx.doi.org/10.1002/lary.27616DOI Listing
December 2018
3 Reads

Perioperative gabapentin and post cesarean pain control: A systematic review and meta-analysis of randomized controlled trials.

Eur J Obstet Gynecol Reprod Biol 2019 Feb 12;233:98-106. Epub 2018 Dec 12.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA. Electronic address:

Cesarean delivery occurs in roughly one third of pregnancies. Effective postoperative pain control is a goal for patients and physicians. Limiting opioid use in this period is important as some percentage of opioid naïve individuals will develop persistent use. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2018.11.026DOI Listing
February 2019
4 Reads
1.627 Impact Factor

Best practice in the management of benign prostatic hyperplasia in the patients requiring anticoagulation.

Ther Adv Urol 2018 Dec 29;10(12):431-436. Epub 2018 Oct 29.

Indiana University School of Medicine, IU Health Physicians Urology, 1801 N. Senate Blvd., Indianapolis, IN 46202-5114, USA.

In today's aging population, urologists are often treating older patients with multiple comorbidities. Lower urinary tract symptoms from benign prostate hyperplasia (LUTS/BPH) is a common condition that affects men, with increasing prevalence as men age. In a subset of patients, the symptoms are too severe or refractory to medical therapy and, therefore, surgical therapy is required to improve their LUTS. Read More

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http://dx.doi.org/10.1177/1756287218807591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295789PMC
December 2018
2 Reads

Interventional Pain Management and Female Pelvic Pain: Considerations for Diagnosis and Treatment.

Semin Reprod Med 2018 Mar 19;36(2):159-163. Epub 2018 Dec 19.

Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Chronic pelvic pain (CPP) is a recurring and/or constant pain of at least six months duration that has resulted in either functional or psychological disability that can require interventional treatments. Chronic pelvic pain can be visceral, somatic, neuropathic, or a combination. Patients with CPP often suffer from concurrent bowel or bladder dysfunction, sexual dysfunction, depression, and anxiety. Read More

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http://dx.doi.org/10.1055/s-0038-1676104DOI Listing
March 2018
3 Reads

Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop.

J Am Geriatr Soc 2019 Feb 7;67(2):371-380. Epub 2018 Dec 7.

Cardiovascular Division, Department of Internal Medicine, Washington University, St. Louis, Missouri.

Objectives: To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD).

Design: Consensus meeting.

Setting: Multidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6-7, 2017. Read More

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http://dx.doi.org/10.1111/jgs.15634DOI Listing
February 2019
7 Reads

Periprocedural Antithrombotic Management from a Patient Perspective: A Qualitative Analysis.

Am J Med 2018 Dec 3. Epub 2018 Dec 3.

Center for Bioethics and Social Science in Medicine; Frankel Cardiovascular Center. Electronic address:

Background: Periprocedural antithrombotic medication management is a complex, often confusing process for patients and their providers. Communication difficulties often lead to suboptimal medication management, resulting in delayed or canceled procedures.

Methods: We conducted telephone surveys with patients taking chronic antithrombotic medications who had recently undergone an endoscopy procedure. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029343183114
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http://dx.doi.org/10.1016/j.amjmed.2018.11.020DOI Listing
December 2018
26 Reads

Perioperative Management of the Rheumatoid Patient.

Clin Podiatr Med Surg 2019 Jan 25;36(1):115-130. Epub 2018 Oct 25.

Foot and Ankle Surgery Residency, SSM Health DePaul Hospital, 12303 DePaul Drive, Suite B1, St Louis, MO 63044, USA. Electronic address:

Rheumatoid arthritis is a complex disease state with multiple associated comorbidities. Perioperative evaluation of the rheumatoid patient from a multidisciplinary approach is necessary to achieve favorable outcomes. A complete history and physical, laboratory, cervical, cardiovascular, pulmonary, and medication assessment before surgery should be performed. Read More

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http://dx.doi.org/10.1016/j.cpm.2018.08.005DOI Listing
January 2019
7 Reads

Perioperative Cardiac Considerations in the Surgical Patient.

Clin Podiatr Med Surg 2019 Jan 30;36(1):103-113. Epub 2018 Oct 30.

Department of Adult Cardiovascular Medicine, Joan C. Edwards School of Medicine, Marshall University, 1249 15th Street, Suite 4000, Huntington, WV 25701, USA. Electronic address:

The ability to identify and guide evaluation of the patient with cardiac disease represents a necessary skill for success in surgery of the foot and ankle. Common risk factors, such as diabetes and peripheral arterial disease, are encountered in podiatric practice. Recognition of patients at risk for cardiac disease and a predilection for sustaining a major adverse cardiac event perioperatively advocates for preoperative cardiology consultation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08918422183007
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http://dx.doi.org/10.1016/j.cpm.2018.09.001DOI Listing
January 2019
10 Reads

Arteriovenous Graft for Hemodialysis: Effect of Cryotherapy on Postoperative Pain and Edema.

Pain Manag Nurs 2018 Nov 10. Epub 2018 Nov 10.

Department of General Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou City, Guangdong Province, China.

Background: Arteriovenous grafting offers an alternative for patients whose vessels are unsuitable for arteriovenous fistula. However, as a result of subcutaneous tunnel dissection, postoperative pain and edema of the operated limb present early after surgery. As a traditional therapeutic approach, cryotherapy has the ability to suppress postoperative pain and edema. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15249042173052
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http://dx.doi.org/10.1016/j.pmn.2018.07.002DOI Listing
November 2018
18 Reads

Relationship Between Preoperative Antidepressant and Antianxiety Medications and Postoperative Hospital Length of Stay.

Anesth Analg 2019 Feb;128(2):248-255

From the Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New York, New York.

Background: Patients on antidepressant or antianxiety medications often have complex perioperative courses due to difficult pain management, altered coping mechanisms, or medication-related issues. This study examined the relationship between preoperative antidepressants and antianxiety medications on postoperative hospital length of stay while controlling for confounding variables.

Methods: From an administrative database of 48,435 adult patients who underwent noncardiac surgery from 2011 to 2014 at a single, large urban academic institution, multivariable zero-truncated negative binomial regression analyses controlling for age, sex, medical comorbidities, and surgical type were performed to assess whether preoperative exposure to antidepressant or antianxiety medication use was associated with postoperative hospital length of stay. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003910DOI Listing
February 2019
9 Reads

Comparison of three different ketofol proportions in children undergoing dental treatment.

Authors:
G Kip D Atabek M Bani

Niger J Clin Pract 2018 Nov;21(11):1501-1507

Department of Paediatric Dentistry, Faculty of Dentistry, Gazi University, Ankara, Turkey.

Aim And Background: Sedation is gaining popularity among dental procedures in children. Ketamine and propofol mixture, known as ketofol, is one of the promising choices in sedation protocols; however, there is no consensus on the exact ratio of ketamine plus propofol especially in dental practice. The aim of present study was to compare perioperative side effect profiles, recovery profiles, and satisfaction rates of both parents' and dentists' following three different ratio of ketofol mixtures in children undergoing dental treatment. Read More

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http://dx.doi.org/10.4103/njcp.njcp_188_18DOI Listing
November 2018
2 Reads

Short-term perioperative iron in major orthopedic surgery: state of the art.

Vox Sang 2019 Jan 9;114(1):3-16. Epub 2018 Nov 9.

Perioperative Transfusion Medicine, School of Medicine, Málaga, Spain.

In major orthopaedic surgery, it is recommended to detect and correct preoperative anaemia several weeks prior to surgery. However, in many cases, the procedure is urgent or the patient is evaluated shortly before the intervention. As iron deficiency is the leading cause of perioperative anaemia, an exhaustive review of the literature was performed to assess the efficacy and safety of short-term perioperative intravenous, with or without erythropoietin, or postoperative oral or intravenous supplementation in major orthopaedic surgery. Read More

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http://dx.doi.org/10.1111/vox.12718DOI Listing
January 2019
6 Reads

Should a patient with rheumatoid arthritis be a kidney donor?

Clin Rheumatol 2019 Jan 8;38(1):251-256. Epub 2018 Nov 8.

Division of Rheumatology, Departments of Medicine, Keck School of Medicine, University of Southern California and Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA.

We cared for a woman with sero-positive rheumatoid arthritis (RA), in clinical remission on oral methotrexate (MTX) and hydroxychloroquine, who wished to donate a kidney to a brother with end-stage renal disease (ESRD). We could find scant literature about this unusual clinical circumstance, and therefore review pertinent aspects of renal disease in RA, perioperative medical management, maintenance of disease remission, outcomes for RA patients who have donated kidneys, and relevant ethical issues. Renal complications in RA are not uncommon, with as many as 50% of patients at risk of reduced eGFR. Read More

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http://link.springer.com/10.1007/s10067-018-4350-5
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http://dx.doi.org/10.1007/s10067-018-4350-5DOI Listing
January 2019
11 Reads

Effectiveness and Sustainability of a Standardized Care Pathway Developed with Use of Lean Process Mapping for the Treatment of Patients Undergoing Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis.

J Bone Joint Surg Am 2018 Nov;100(21):1864-1870

Division of Orthopaedic Surgery & Sports Medicine (M.E.O. and B.D.M.), Center for Translational Science (H.G.-D.), and Division of Anesthesiology, Pain and Perioperative Management (J.C. and S.R.P.), Children's National Health System, Washington, DC.

Background: Recent changes in health care have begun to shift the industry from a volume-based to a value-based focus. This shift has led to standardized care pathways that decrease care variability, improve outcomes, and decrease cost. Although numerous studies have described standardized pathways for adolescent idiopathic scoliosis (AIS), few have demonstrated sustainability. Read More

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http://dx.doi.org/10.2106/JBJS.18.00079DOI Listing
November 2018
10 Reads
5.280 Impact Factor

MCA-to-MCA Bypass with Interposition Graft for Ruptured Mycotic Middle Cerebral Artery Aneurysm.

World Neurosurg 2019 Feb 2;122:195. Epub 2018 Nov 2.

Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address:

Mycotic aneurysm, also referred to as infected aneurysm, is a rare entity that may result from the bacterial infection or infective endocarditis. The treatment options include conservative medication and endovascular or direct microsurgical intervention. However, the optimal strategy remains unknown and cerebral revascularization may be required in some rare cases. Read More

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http://dx.doi.org/10.1016/j.wneu.2018.10.167DOI Listing
February 2019
1 Read

Preoperative Management of Medications.

Anesthesiol Clin 2018 Dec;36(4):663-675

Department of Anesthesiology and Perioperative Medicine, Centro de Desarrollo de Destrezas Medicas, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vaco de Quiroga #15, Col. Belisario Dominguez Sección XVI, Mexico City 14080, Mexico.

Increasingly complex medication regimens for many comorbidities in patients for planned surgical and procedural interventions necessitate detailed preoperative evaluation of the pharmacologic therapy, including the indications, the specific drugs, and dosing amount and interval. The implications of continuing or withholding these agents in the perioperative period need to be elucidated, as well as the risks of interactions and side effects. A comprehensive plan of the management of the therapeutic agents should be devised during the preoperative visit, with input from all relevant specialists, and clearly communicated to the patients in a format that ensures their comprehension and consistent compliance. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S19322275183007
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http://dx.doi.org/10.1016/j.anclin.2018.07.012DOI Listing
December 2018
14 Reads

Perioperative Medication Management in Adult Cardiac Surgery: The 2017 European Association for Cardio-Thoracic Surgery Guidelines.

J Cardiothorac Vasc Anesth 2019 02 27;33(2):304-306. Epub 2018 Sep 27.

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.

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http://dx.doi.org/10.1053/j.jvca.2018.09.029DOI Listing
February 2019
6 Reads

[Surgery for inflammatory rheumatic joint destruction].

Authors:
S Rehart M Henniger

Orthopade 2018 Nov;47(11):933-938

Klinik für Orthopädie und Unfallchirurgie, Orthopädische Rheumatologie, AGAPLESION MARKUS KRANKENHAUS, Akademisches Lehr-KH der Goethe-Universität, Wilhelm-Epstein-Str. 4, 60431, Frankfurt am Main, Deutschland.

Orthopaedic and traumatologic involvement in patients with rheumatic diseases require extensive knowledge of these immunologically impairing illnesses. This concerns both the handling of medication and conservative treatment. The destructive processes of the joints and the spine follow established pathways. Read More

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http://dx.doi.org/10.1007/s00132-018-03657-7DOI Listing
November 2018
10 Reads

Perioperative Management and In-Hospital Outcomes After Minimally Invasive Repair of Pectus Excavatum: A Multicenter Registry Report From the Society for Pediatric Anesthesia Improvement Network.

Anesth Analg 2019 Feb;128(2):315-327

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Background: There are few comparative data on the analgesic options used to manage patients undergoing minimally invasive repair of pectus excavatum (MIRPE). The Society for Pediatric Anesthesia Improvement Network was established to investigate outcomes for procedures where there is significant management variability. For our first study, we established a multicenter observational database to characterize the analgesic strategies used to manage pediatric patients undergoing MIRPE. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003829DOI Listing
February 2019
11 Reads
3.472 Impact Factor

Comparing the Efficacy of IV Ibuprofen and Ketorolac in the Management of Postoperative Pain Following Arthroscopic Knee Surgery. A Randomized Double-Blind Active Comparator Pilot Study.

Front Surg 2018 3;5:59. Epub 2018 Oct 3.

Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.

Acute postoperative pain following knee arthroscopy is common in orthopedic surgeries. Managing pain postoperatively combines usage of opioids and non-steroidal anti-inflammatory drugs. The aim of this clinical study was to assess the efficacy of two different analgesic treatment regimens: intravenous (IV) ibuprofen and IV ketorolac for the treatment of postoperative pain pertaining to arthroscopic knee surgery. Read More

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http://dx.doi.org/10.3389/fsurg.2018.00059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178884PMC
October 2018
16 Reads

Regional analgesia in neonates undergoing thoracoabdominal surgeries: A pilot study.

J Neonatal Perinatal Med 2018 Oct 10. Epub 2018 Oct 10.

University at Buffalo, Oishei Children's Hosptial, Buffalo, NY, USA.

Objective: The primary aim of this pilot study was to assess feasibility and to evaluate if peri-operative pain management with regional analgesia resulted in decreased use of narcotic medication and earlier return to preoperative respiratory/nutritional status.

Study Design: Cases were defined as infants who received regional analgesia as part of their perioperative anesthetic management. Controls were matched for surgical procedures without regional analgesia. Read More

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http://www.medra.org/servlet/aliasResolver?alias=iospress&am
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http://dx.doi.org/10.3233/NPM-1827DOI Listing
October 2018
13 Reads

Improved Medication Management With Introduction of a Perioperative and Prescribing Pharmacist Service.

J Pharm Pract 2018 Oct 8:897190018804961. Epub 2018 Oct 8.

2 Department of Anaesthesia, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia.

Background: The medication lists in pre-admission clinic (PAC) questionnaires completed by patients prior to surgery are often inaccurate, potentially leading to medication errors during hospitalization. Studies have shown pharmacists are more accurate when obtaining a medication history and transcribing prescription orders, thereby reducing errors.

Objective: To evaluate the impact of a PeRiopErative and Prescribing (PREP) pharmacist on postoperative medication management. Read More

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http://journals.sagepub.com/doi/10.1177/0897190018804961
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http://dx.doi.org/10.1177/0897190018804961DOI Listing
October 2018
5 Reads

Matched-Pair Analysis of Local Infiltration Analgesia in Total Knee Arthroplasty: Patient Satisfaction and Perioperative Pain Management in 846 Cases.

J Knee Surg 2018 Oct 6. Epub 2018 Oct 6.

Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Germany.

In the recent past, numerous studies evaluating local infiltration analgesia (LIA) with controversial results have been reported. Efforts have been made to improve patients' outcome regarding operation techniques and material, as well as pain management and anesthetic methods. In this study, postoperative pain management and patient satisfaction were evaluated in patients undergoing total knee replacement surgery with or without intraoperative LIA. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1672156
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http://dx.doi.org/10.1055/s-0038-1672156DOI Listing
October 2018
4 Reads

Pain monitoring and management in a rehabilitation setting after total joint replacement.

Medicine (Baltimore) 2018 Oct;97(40):e12484

Physical Medicine and Rehabilitation Unit, IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy.

Total hip replacement (THR) and, particularly, total knee replacement (TKR), are painful surgical procedures. Effective postoperative pain management leads to a better and earlier functional recovery and prevents chronic pain. Studies on the control of pain during the postoperative rehabilitation period are not common. Read More

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http://dx.doi.org/10.1097/MD.0000000000012484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200489PMC
October 2018
5 Reads

Survey of the management of perioperative bridging of anticoagulation and antiplatelet therapy in neurosurgery.

Acta Neurochir (Wien) 2018 Nov 20;160(11):2077-2085. Epub 2018 Sep 20.

Department of Neurosurgery, University Hospital Tuebingen, Eberhard Karls University Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.

Background: A growing number of patients on anticoagulation or antiplatelet therapy (APT) are planned for elective surgery. The management of perioperative anticoagulation and APT is challenging because it must balance the risk of thromboembolism and bleeding, and specific recommendations for the management of bridging in neurosurgical patients are lacking. We surveyed German neurosurgical centers about their management of perioperative bridging of anticoagulation and APT to provide an overview of the current bridging policy. Read More

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http://dx.doi.org/10.1007/s00701-018-3679-5DOI Listing
November 2018
4 Reads

The Effect of Preoperative Medications on Length of Stay, Inpatient Pain, and Narcotics Consumption After Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Clin Spine Surg 2019 Feb;32(1):E37-E42

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Study Design: This is a retrospective cohort study.

Objective: To determine the association between preoperative medications and length of stay, inpatient pain, and narcotics consumption after a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary Of Background Data: Previous studies have identified risk factors for increased length of hospital stay, inpatient pain, and narcotics consumption. Read More

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http://dx.doi.org/10.1097/BSD.0000000000000713DOI Listing
February 2019
3 Reads

Multi-disciplinary approach to perioperative risk assessment and post-transplant management for liver transplantation in a patient at risk for Brugada syndrome.

J Perioper Pract 2018 Sep 13:1750458918796013. Epub 2018 Sep 13.

5 Duke Division of Gastroenterology, Duke University School of Medicine, Durham, NC, USA.

Brugada syndrome, an autosomal dominant genetic disorder, is characterised by abnormal electrocardiogram findings and increased risk of ventricular tachyarrhythmias and sudden cardiac death. Our report describes the multi-disciplinary perioperative management of a 28-year-old patient presenting to the Duke Transplant Center with a familial sodium channel gene SCN51 mutation concerning Brugada syndrome. We discuss the preparatory work-up, medication review and appropriate post-surgical follow-up for patients undergoing liver transplant surgery with cardiac monitoring. Read More

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http://dx.doi.org/10.1177/1750458918796013DOI Listing
September 2018
3 Reads

Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-Like Symptoms After Cataract Surgery.

Cornea 2018 Dec;37(12):1535-1541

Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL.

Purpose: To evaluate the epidemiology of persistent postsurgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery.

Methods: This single-center study included 119 individuals whose cataract surgeries were performed by a single surgeon at the Bascom Palmer Eye Institute and who agreed to participate in a phone survey 6 months after surgery. Patients were divided into 2 groups: the PPP group was defined as those with a Dry Eye Questionnaire-5 score ≥6 and without PPP as those with a Dry Eye Questionnaire-5 score <6 at 6 months after cataract surgery. Read More

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http://dx.doi.org/10.1097/ICO.0000000000001741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218275PMC
December 2018
4 Reads

[Oxycodone, piritramide and tramadol for the management of postoperative pain : A registry study on use and effectiveness in clinical routine].

Schmerz 2018 Dec;32(6):427-433

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Background: In the context of improving perioperative pain management and shortening hospital stays, potent oral analgesics, such as slow release opioids, are gaining increasingly in importance.

Objective: The aim of this study was to compare the use and effectiveness of different opioids in postoperative pain treatment in Germany.

Materials And Methods: Using data from the QUIPS database, the records of 5249 patients were evaluated. Read More

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http://dx.doi.org/10.1007/s00482-018-0322-6DOI Listing
December 2018
7 Reads

Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: Prevention and Diagnosis.

Curr Rheumatol Rep 2018 Sep 10;20(11):68. Epub 2018 Sep 10.

Department of Academic Training, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.

Purpose Of Review: Periprosthetic joint infection (PJI) is a devastating complication that can occur following total joint arthroplasty (TJA), causing significant morbidity and often requiring revision surgery. This goal of this manuscript is to review the current evidence for the prevention and diagnosis of PJI in patients with inflammatory arthritis.

Recent Findings: Patients with inflammatory arthritis have a higher risk of PJI after TJA; however, there are several preventive, diagnostic, and therapeutic measures that can be optimized to lower the burden of PJI in this population. Read More

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http://link.springer.com/10.1007/s11926-018-0777-6
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http://dx.doi.org/10.1007/s11926-018-0777-6DOI Listing
September 2018
28 Reads

Goal-directed hemodynamic management in patients undergoing primary debulking gynaecological surgery: A matched-controlled precision medicine study.

Gynecol Oncol 2018 11 7;151(2):299-305. Epub 2018 Sep 7.

Department of Anesthesia, Emergency and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Institute of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.

Background: Usefulness of intraoperative goal-directed hemodynamic management (GDHM) for patients without comorbidities is debated. After clinical implementation of a pulse contour analysis-guided GDHM protocol, which foresees early vasopressor use for recruiting unstressed volume, we conducted a matched-controlled analysis to explore its impact on the amount of fluids intraoperatively administered to patients without comorbidities who underwent extended abdominal surgery for ovarian cancer.

Methods: After 1:1 matching accounting for body mass index, oncologic disease severity and intraoperative blood losses, 22 patients treated according to this GDHM protocol were compared to a control group of 22 patients who had been managed according to the clinical decision of attending physicians, taken without advanced monitoring. Read More

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http://dx.doi.org/10.1016/j.ygyno.2018.08.034DOI Listing
November 2018
4 Reads