1,785 results match your criteria Perioperative Medication Management


The Pain Nurse Practitioner and Pain Nurse's Role and Views on Opioid Management in Australia: A National Questionnaire Survey.

Pain Manag Nurs 2021 Jun 6. Epub 2021 Jun 6.

Faculty of Nursing, Latrobe University, The Alfred Centre, Melbourne, Australia.

Background: The demand for access to Australian pain management services is growing. The dual crisis of opioid misuse and chronic pain, means pain nurses and nurse practitioners (NPs) have a unique opportunity to meet clinical demands and advance their scope of practice.

Aims: To understand the role of pain nurses and pain NPs across Australia and explore their perceptions of current opioid management. Read More

View Article and Full-Text PDF

Perioperative Management of Antirheumatic Medications in Patients with RA and SLE Undergoing Elective Foot and Ankle Surgery: A Critical Analysis Review.

JBJS Rev 2021 06 8;9(6). Epub 2021 Jun 8.

Department of Orthopaedic Surgery, University of Michigan Health System, Ann Arbor, Michigan.

»: Recent literature has shown that continued use rather than discontinuation of various antirheumatic agents throughout the perioperative period may present an opportunity to mitigate the risks of elective surgery.

»: For patients with rheumatoid arthritis and systemic lupus erythematosus, perioperative management of medication weighs the risk of infection against the risk of disease flare when immunosuppressive medications are withheld.

»: Broadly speaking, current evidence, although limited in quality, supports perioperative continuation of disease-modifying antirheumatic drugs, whereas biologic drugs should be withheld perioperatively, based on the dosing interval of the specific drug. Read More

View Article and Full-Text PDF

[Effect of auricular point sticking therapy on perioperative pain in patients with partial lung resection].

Zhongguo Zhen Jiu 2021 Jun;41(6):603-7

1Department of Acupuncture and Moxibustion, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; 2Qinghai Armed Police Force Hospital; 3China News of TCM.

Objective: To observe the analgesic effect of auricular point sticking therapy during the perioperative stage in the patients with partial lung resection.

Methods: A total of 92 patients with partial lung resection were randomized into an auricular point group (31 cases, 1 case dropped off), the sham-auricular point group (30 cases) and a medication group (31 cases, 1 case dropped off). The routine medication for analgesia was provided in all of the three groups. Read More

View Article and Full-Text PDF

Telemedicine for Follow-up Management of Patients After Liver Transplantation: Cohort Study.

JMIR Med Inform 2021 May 17;9(5):e27175. Epub 2021 May 17.

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Background: Technical capabilities for performing liver transplantation have developed rapidly; however, the lack of available livers has prompted the utilization of edge donor grafts, including those donated after circulatory death, older donors, and hepatic steatosis, thereby rendering it difficult to define optimal clinical outcomes.

Objective: We aimed to investigate the efficacy of telemedicine for follow-up management after liver transplantation.

Methods: To determine the efficacy of telemedicine for follow-up after liver transplantation, we performed a clinical observation cohort study to evaluate the rate of recovery, readmission rate within 30 days after discharge, mortality, and morbidity. Read More

View Article and Full-Text PDF

COVID-19 impact and response by Canadian pain clinics: A national survey of adult pain clinics.

Can J Pain 2020 Sep 10;4(1):204-209. Epub 2020 Sep 10.

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

: As the result of public health authority responses to the COVID-19 pandemic, pain clinics have had to cease providing in-person appointments to reduce contact between patients and staff. Over the past decade, Canadians living with chronic pain have faced long waiting times for care within multidisciplinary pain clinics. We are concerned that ceasing in-person pain services exacerbates the daily hardships already faced by Canadians living with chronic pain. Read More

View Article and Full-Text PDF
September 2020

Nanoceutical Adjuvants as Wound Healing Material: Precepts and Prospects.

Int J Mol Sci 2021 Apr 29;22(9). Epub 2021 Apr 29.

Department of Applied Physiology, Faculty of Medicine, University of Miyazaki, Miyazaki 8891692, Japan.

Dermal wound healing describes the progressive repair and recalcitrant mechanism of 12 damaged skin, and eventually, reformatting and reshaping the skin. Many probiotics, nutritional supplements, metal nanoparticles, composites, skin constructs, polymers, and so forth have been associated with the improved healing process of wounds. The exact mechanism of material-cellular interaction is a point of immense importance, particularly in pathological conditions such as diabetes. Read More

View Article and Full-Text PDF

Safety and Efficacy of Single-Dose Ketorolac for Postoperative Pain Management After Primary Palatoplasty: A Prospective Cohort Study With Historical Controls.

Cleft Palate Craniofac J 2021 May 4:10556656211012864. Epub 2021 May 4.

Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA.

Objective: To analyze safety and efficacy of single-dose ketorolac after primary palatoplasty (PP).

Design: Consecutive cohort of patients undergoing PP, comparing to historical controls. A large academic children's hospital. Read More

View Article and Full-Text PDF

Spinal drainage complications after aortic surgery.

J Vasc Surg 2021 May 1. Epub 2021 May 1.

Department of Vascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.

Objective/background: Spinal drain (SD) placement is an adjunct used in open and endovascular aortic surgery to mitigate the risk of spinal cord injury. SD placement can lead to subdural hematoma and intracranial hemorrhage (SDH/ICH). Previous studies have highlighted a correlation between incidence of SDH/ICH and amount of cerebrospinal fluid (CSF) drained. Read More

View Article and Full-Text PDF

Safety, efficacy, and analysis of key parameters after prophylactic administration of a sustained-release formulation of azithromycin in lung cancer surgery.

Ann Palliat Med 2021 May 8;10(5):5098-5107. Epub 2021 Apr 8.

Department of Surgical Oncology, Nagasaki University Graduate School of Medicine, Nagasaki, Japan; Medical-Engineering Hybrid Professional Development Program, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Background: The current use of prophylactic antibiotics for lung cancer surgery requires modification in aging individuals with impaired lung function. A sustained-release formulation of azithromycin (AZM-SR) could help resolve some of these challenges with its sustained antibacterial and anti-inflammatory effects. The aim of this study was to examine the safety and efficacy of AZM-SR in lung cancer surgery as well as its anti-inflammatory effect. Read More

View Article and Full-Text PDF

Limited use of nonopioid analgesics after pediatric ambulatory surgery.

J Opioid Manag 2021 Mar-Apr;17(2):101-107

Department of Anesthesia and Perioperative Care, University of California San Francisco School of Medicine, San Francisco, California. ORCID: https://orcid.org/0000-0002-7061-066X.

Objective: This study sought to determine the rate at which nonopioid analgesics were utilized in postoperative pain management plans after pediatric ambulatory surgery in patients who were also prescribed postoperative opioids.

Design: Retrospective cohort analysis.

Participants: Patients ≤ 21 years old who were prescribed opioid medications after undergoing ambulatory surgery at a tertiary-care medical center. Read More

View Article and Full-Text PDF

The role of magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease.

Curr Opin Gastroenterol 2021 Jul;37(4):384-389

Medical University of Vienna, Department of General Surgery, Upper-GI-Service, Wien, Austria.

Purpose Of Review: Magnetic sphincter augmentation (MSA) has been designed as a less disruptive and more standardized laparoscopic surgical procedure than fundoplication for patients with early stage gastroesophageal reflux disease (GERD). We analyzed the more recent literature in search of updates regarding indications, technique, perioperative management, and long-term outcomes.

Recent Findings: Over the years, the procedure of MSA has evolved to including full hiatus repair rather than relying on the preservation of the phreno-esophageal ligament. Read More

View Article and Full-Text PDF

Prevention of postoperative delirium through the avoidance of potentially inappropriate medications in a geriatric surgical patient.

BMJ Case Rep 2021 Apr 19;14(4). Epub 2021 Apr 19.

Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA.

We demonstrate the utility of risk stratification for postoperative delirium in geriatric patients and show that postoperative delirium can be prevented in high-risk patients when potentially inappropriate medications (PIMs) (medications that are best avoided in older adults) are avoided. In this case, a 65-year-old woman underwent two debridement procedures with similar presurgical risk for postoperative delirium. There was no risk stratification or preoperative cognitive assessment in the first procedure, she received PIMs and developed postoperative delirium. Read More

View Article and Full-Text PDF

Outcomes of Surgical Treatment for Mycobacterium abscessus Complex Pulmonary Disease.

Ann Thorac Surg 2021 Apr 8. Epub 2021 Apr 8.

Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan.

Background: Mycobacterium abscessus complex pulmonary disease is notoriously difficult to treat by medication alone. We report our experience with resectional surgery combined with pre- and postoperative multidrug chemotherapy for the treatment of patients with Mycobacterium abscessus complex pulmonary disease.

Methods: This is a retrospective review of 33 patients undergoing lung resection for Mycobacterium abscessus complex pulmonary disease at a single center in Japan between January 2008 and December 2019. Read More

View Article and Full-Text PDF

Perioperative management of cranial diabetes insipidus in a patient requiring a tracheostomy.

BMJ Case Rep 2021 Apr 9;14(4). Epub 2021 Apr 9.

Department of Otolaryngology and Head and Neck Surgery, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.

Cranial diabetes insipidus (DI), which can cause life-threatening dehydration, is treated with desmopressin, often intranasally. This is challenging in patients whose nasal airflow is altered, such as those requiring tracheostomy. We report the case of a patient, taking intranasal desmopressin for cranial DI, who underwent partial glossectomy, free-flap reconstruction and tracheostomy. Read More

View Article and Full-Text PDF

Combined spinal-epidural anesthesia for abdominoplasty and liposuction in Limb-Girdle Muscular Dystrophy: case report.

Braz J Anesthesiol 2021 May-Jun;71(3):299-301. Epub 2021 Apr 3.

Universidade Federal do Maranhão (UFMA), São Luís, MA, Brazil. Electronic address:

We report the anesthetic management with combined spinal-epidural in a patient with limb-girdle muscular dystrophy type 2A, submitted to abdominoplasty and liposuction. The patient had onset of symptoms at 8 years old, diagnosed by muscular biopsy, presenting muscle weakness in the scapular and pelvic girdles, with reduced mobility. We performed monitorization with noninvasive blood pressure, oximeter, thermometer, and electrocardiogram. Read More

View Article and Full-Text PDF

Perioperative Pain Management and Opioid Stewardship: A Practical Guide.

Healthcare (Basel) 2021 Mar 16;9(3). Epub 2021 Mar 16.

Department of Surgery, St. Joseph Mercy Hospital Ann Arbor, Ypsilanti, MI 48197, USA.

Surgical procedures are key drivers of pain development and opioid utilization globally. Various organizations have generated guidance on postoperative pain management, enhanced recovery strategies, multimodal analgesic and anesthetic techniques, and postoperative opioid prescribing. Still, comprehensive integration of these recommendations into standard practice at the institutional level remains elusive, and persistent postoperative pain and opioid use pose significant societal burdens. Read More

View Article and Full-Text PDF

Mechanisms, diagnosis, prevention and management of perioperative opioid-induced hyperalgesia.

Pain Manag 2021 Apr 29;11(4):405-417. Epub 2021 Mar 29.

Department of Anesthesiology & Perioperative Pain Medicine, Texas Children's Hospital, Houston, TX 77030, USA.

Opioid-induced hyperalgesia (OIH) occurs when opioids paradoxically enhance the pain they are prescribed to ameliorate. To address a lack of perioperative awareness, we present an educational review of clinically relevant aspects of the disorder. Although the mechanisms of OIH are thought to primarily involve medullary descending pathways, it is likely multifactorial with several relevant therapeutic targets. Read More

View Article and Full-Text PDF

Effect of perioperative acetaminophen on pain management in patients undergoing rotator cuff repair: a prospective randomized study.

J Shoulder Elbow Surg 2021 Mar 24. Epub 2021 Mar 24.

Department of Orthopaedic Surgery, The Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA. Electronic address:

Background: Limiting opioid use in perioperative pain management is currently an important focus in orthopedic surgery. The ability of acetaminophen to reduce postoperative opioid consumption while providing acceptable pain management has not been thoroughly investigated in patients undergoing rotator cuff repair (RCR).

Methods: Patients undergoing primary arthroscopic RCR were prospectively randomized to 1 of 3 treatment groups: Group 1 (control) received both 5 mg of oxycodone every 6 hours as needed and 1000 mg of acetaminophen orally every 6 hours as needed after surgery and had the option to take either medication or both. Read More

View Article and Full-Text PDF

Society of Family Planning clinical recommendations: Management of individuals with bleeding or thrombotic disorders undergoing abortion.

Contraception 2021 Mar 22. Epub 2021 Mar 22.

Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, United States.

Individuals who have bleeding disorders, thrombophilias, a history of venous thromboembolism (VTE), or who are taking anticoagulation medication for other reasons may present for abortion. Clinicians should be aware of risk factors and histories concerning for excessive bleeding and thrombotic disorders around the time of abortion. This document will focus on how to approach abortion planning in these individuals. Read More

View Article and Full-Text PDF

Office hysteroscopy safety and feasibility in women receiving anticoagulation and anti-platelet treatment.

Eur J Obstet Gynecol Reprod Biol 2021 May 17;260:110-113. Epub 2021 Mar 17.

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.

Objectives: More than 60,000 hysteroscopies are performed every year in the UK for common reasons such as heavy menstrual bleeding (HMB) or postmenopausal bleeding. A significant number of women requiring hysteroscopy receive oral anticoagulants and there is often a reluctance to perform these procedures due to bleeding concerns.

Study Design: We are presenting the first proof of concept cohort of patients undergoing minor hysteroscopic procedures while on anticoagulant or antiplatelet medication. Read More

View Article and Full-Text PDF

Psychosis in a primary hyperparathyroidism patient with mild hypercalcemia: A case report.

Medicine (Baltimore) 2021 Mar;100(12):e25248

Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo.

Introduction: Primary hyperparathyroidism (PHPT) is characterized by hypercalcemia and an elevated level of serum parathyroid hormone (PTH). PHPT presents with a complex set of renal, skeletal, and neuropsychological symptoms. Parathyroidectomy (PTX) is a radical treatment that is recommended for all physically symptomatic patients with PHPT. Read More

View Article and Full-Text PDF

Intravenous Smart Pumps During Actual Clinical Use: A Descriptive Comparison of Primary and Secondary Infusion Practices.

J Infus Nurs 2021 May-Jun 01;44(3):128-136

University of Massachusetts Amherst, Institute for Applied Life Sciences and College of Nursing, Amherst, Massachusetts (Dr Giuliano); Center for Nursing Research and Advanced Nursing Practice, Orlando Health, Orlando, Florida (Dr Penoyer and, formerly, Ms Bennett); Parkview Regional Medical Center, Fort Wayne, Indiana (Ms Mahuren).

This descriptive observational study was conducted to increase understanding of medication administration practices during actual clinical use between 2 commonly used, different types of intravenous (IV) smart pumps. Compliance with manufacturer-recommended setup requirements for both primary and secondary infusions and secondary medication administration delay was compared between a head-height differential system and a cassette system. A total of 301 medication administration observations were included in this study: 102 (34%) for the linear peristaltic IV smart pump (medical-surgical: N = 51; critical care: N = 51) and 199 (66%) for the cassette pump (medical-surgical: N = 88; critical care: N = 111). Read More

View Article and Full-Text PDF

The use of bone turnover markers for monitoring the treatment of osteoporosis in postmenopausal females undergoing total knee arthroplasty: a prospective randomized study.

J Orthop Surg Res 2021 Mar 17;16(1):195. Epub 2021 Mar 17.

Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, NO. 157 Xiwu Road, Xi'an, 710004, Shaanxi, People's Republic of China.

Background: Osteoporosis (OP) and osteoarthritis (OA) commonly coexist in postmenopausal females. The decrease in bone density and increase in bone resorption in postmenopausal females with OP may consequently affect the surgical outcome of total knee arthroplasty (TKA). However, clinicians often ignore monitoring the treatment of OP in the perioperative management of TKA. Read More

View Article and Full-Text PDF

[Perioperative Anesthesiologic Management: Risk Assessment and Preoperative Improvement of Patient Conditions].

Anasthesiol Intensivmed Notfallmed Schmerzther 2021 Mar 16;56(3):159-173. Epub 2021 Mar 16.

With patient safety being anesthesiologists' top priority, the focus of preoperative assessment must be to reduce perioperative morbidity and mortality of each patient entrusted to us. Perioperative risk is multifactorial and depends on the extent of surgery and the preoperative condition of the patient.The three main causes of unexpected perioperative death are cardiac arrest, hypoxemia and acute bleeding. Read More

View Article and Full-Text PDF

Minimizing Opioids After Joint Operation: Protocol to Decrease Postoperative Opioid Use After Primary Total Knee Arthroplasty.

Fed Pract 2021 Feb;38(2):e1-e7

and are Physician Assistants, is a Family Nurse Practitioner, and are Attending Orthopedic Surgeons, all at US Department of Veterans Affairs Portland Health Care System in Oregon. is an Orthopedic Surgery Resident, and Kenneth Gundle is an Attending Physician, both in the Orthopedic Department at Oregon Health and Sciences University in Portland.

Background: For decades, opioids have been the mainstay in pain management after total joint arthroplasty despite evidence that their use should be curtailed. To limit unnecessary prescribing of opioids, the US Department of Veterans Affairs (VA) Portland Health Care System Total Joints Service implemented the Minimizing Opioids After Joint Operation (MOJO) postoperative pain protocol in 2018 to reduce opioid use following total knee arthroplasty (TKA). This protocol included reductions of inpatient and outpatient opioid prescribing, preoperative optimization, use of perioperative nerve blocks, and surgery without a tourniquet. Read More

View Article and Full-Text PDF
February 2021

Including Medical Management in the Urologic Approach to Idiopathic Retroperitoneal Fibrosis.

Urology 2021 Jun 11;152:167-172. Epub 2021 Mar 11.

Department of Urology, Michigan Medicine.

Objective: To characterize the timing and effectiveness of medical management in resolving stent-dependent ureteral compression secondary to idiopathic retroperitoneal fibrosis (RPF), the long-term relevant outcomes, and the side effects of treatment.

Methods: A retrospective review of RPF patients diagnosed from 2002-2018 was performed. Patients with hydronephrosis due to ureteral involvement that were managed with medication and with temporary stenting as needed, but without initial ureterolysis, were included. Read More

View Article and Full-Text PDF

Preoperative Management of Endocrine, Hormonal, and Urologic Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement.

Mayo Clin Proc 2021 06 10;96(6):1655-1669. Epub 2021 Mar 10.

Division of General Internal Medicine, Mayo Clinic, Rochester, MN.

Perioperative medical management is challenging due to the rising complexity of patients presenting for surgical procedures. A key part of preoperative optimization is appropriate management of long-term medications, yet guidelines and consensus statements for perioperative medication management are lacking. Available resources utilize the recommendations derived from individual studies and do not include a multidisciplinary focus or formal consensus. Read More

View Article and Full-Text PDF

Implementing fast-track in total hip arthroplasty: rapid mobilization with low need for pain medication and low pain values : Retrospective analysis of 102 consecutive patients.

Z Rheumatol 2021 Mar 11. Epub 2021 Mar 11.

Department of Orthopedics, University Medical Center Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Germany.

Introduction: Total hip arthroplasty (THA) is reported to be one of the most painful surgical procedures. Perioperative management and rehabilitation patterns are of great importance for the success of the procedure. The aim of this cohort study was the evaluation of function, mobilization and pain scores during the inpatient stay (6 days postoperatively) and 4 weeks after fast-track THA. Read More

View Article and Full-Text PDF

Opioid-Associated Out-of-Hospital Cardiac Arrest: Distinctive Clinical Features and Implications for Health Care and Public Responses: A Scientific Statement From the American Heart Association.

Circulation 2021 Apr 8;143(16):e836-e870. Epub 2021 Mar 8.

Opioid overdose is the leading cause of death for Americans 25 to 64 years of age, and opioid use disorder affects >2 million Americans. The epidemiology of opioid-associated out-of-hospital cardiac arrest in the United States is changing rapidly, with exponential increases in death resulting from synthetic opioids and linear increases in heroin deaths more than offsetting modest reductions in deaths from prescription opioids. The pathophysiology of polysubstance toxidromes involving opioids, asphyxial death, and prolonged hypoxemia leading to global ischemia (cardiac arrest) differs from that of sudden cardiac arrest. Read More

View Article and Full-Text PDF

Healing rates after rotator cuff repair for patients taking either celecoxib or placebo: a double-blind randomized controlled trial.

JSES Int 2021 Mar 8;5(2):247-253. Epub 2020 Dec 8.

University of Southern California, Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA.

Background: Use of anti-inflammatory medications (NSAIDs) is an important component of multimodal pain control after orthopedic procedures to avoid opioid overutilization and abuse. However, the deleterious effects of NSAIDs on tendon healing are of particular concern in rotator cuff repair (RCR). The purpose of this study was to evaluate the effect of celecoxib or placebo on healing rates after RCR when administered in the perioperative and immediate postoperative period using MRI evaluation at one year postoperatively. Read More

View Article and Full-Text PDF