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Perioperative surgical home

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https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#1
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29759288/perioperative-surgical-home-for-the-patient-with-chronic-pain
#2
REVIEW
Talal W Khan, Smith Manion
The management of acute pain for the phenotypically different patient who suffers from chronic pain is challenging. The care of these patients is expensive and siloed. The physician-led, multidisciplinary, patient-centric, care coordination framework of the perioperative surgical home is an optimal vehicle for the management of these patients. The engagement of physician anesthesiologists in the optimization, in-hospital management, and postdischarge care of the patient with chronic pain will lead to improved outcomes, reduced health care expenditures, and improve the health of this challenging population...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29742719/cauda-equina-syndrome-following-an-uneventful-spinal-anesthesia-in-a-patient-undergoing-drainage-of-the-bartholin-abscess-a-case-report
#3
Waldo Merino-Urrutia, Milca Villagrán-Schmidt, Priscilla Ulloa-Vásquez, Rubén Carrasco-Moyano, Alberto Uribe, Nicoleta Stoicea, Sergio D Bergese
RATIONALE: Neuraxial anesthesia is a commonly used type of regional anesthesia. Cauda equina syndrome is an unusual and severe complication of neuraxial anesthesia, and is caused by damage to the sacral roots of the neural canal. We present a case of cauda equina syndrome following spinal anesthesia in a patient who underwent Bartholin abscess drainage. PATIENT CONCERNS: A 23-year old female scheduled to undergo surgical drainage of Bartholin abscess. Spinal anesthesia was performed with bupivacaine and fentanyl...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#4
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29690755/perioperative-surgical-home-a-new-scope-for-future-anesthesiology
#5
Min A Kwon
The health care system is changing from 'pay for volume' to 'pay for value.' These changes are turning health care delivery into a more cost-effective and coordinated care setup that drives hospitals to lower costs and greater quality gains. The present perioperative care service in Korea has proven to be costly, fragmented, and neither evidence-based nor patient- centered. Recently, a new concept of a perioperative care model termed perioperative surgical home (PSH) has been proposed. The PSH is a patient-centered, team-based, and coordinated perioperative care setup, composed of the head anesthesiologist-perioperativist in tandem with dedicated nurse practitioners and other PSH team doctors...
April 25, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29685712/no-difference-in-major-complication-and-readmission-rates-following-simultaneous-bilateral-vs-unilateral-total-hip-arthroplasty
#6
Mina W Morcos, Adam Hart, John Antoniou, Olga L Huk, David J Zukor, Stephane G Bergeron
BACKGROUND: Simultaneous bilateral total hip arthroplasty (THA) is an attractive option for patients with osteoarthritis as it requires a single anesthetic and hospitalization. Nonetheless, serious concerns remain over the perioperative safety and rate of hospital readmission. The purpose of the present study was to compare the rate of 30-day major complications and hospital readmissions between patients undergoing simultaneous bilateral vs unilateral THA using the National Surgical Quality Improvement Program database...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29672387/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation-erratum
#7
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29627391/chinese-expert-consensus-on-enhanced-recovery-after-hepatectomy-version-2017
#8
REVIEW
Weidong Jia, Wenbin Liu, Xiaofei Qiao
Enhanced recovery after surgery (ERAS) is a series of perioperative optimized treatment measures based on evidence-based medicine which can control perioperative pathological and physiological responses, reduce surgical trauma and postoperative stress, and then achieve rapid recovery. This is a new concept in the 21st century, which is a revolution to the medical treatment and rehabilitation mode. Based on the clinical application study and expert experience in present ERAS in hepatectomy field at home and abroad, Chinese Expert Consensus on Enhanced Recovery After Hepatectomy (Version 2017) is established...
April 4, 2018: Asian Journal of Surgery
https://www.readbyqxmd.com/read/29609705/ambulatory-surgery-has-minimal-impact-on-sleep-parameters-a-prospective-observational-trial
#9
Arlene J Hudson, Robert J Walter, John Flynn, Dale F Szpisjak, Cara Olsen, Matthew Rodgers, Vincent F Capaldi, Brent McDuffie, Christopher J Lettieri
STUDY OBJECTIVES: The presence of obstructive sleep apnea (OSA) in ambulatory surgical patients causes significant perioperative concern; however, few data exist to guide clinicians' management decisions. The objective of this study was to measure changes in perioperative sleep parameters among an ambulatory surgery population. METHODS: This study is a prospective, observational study of ambulatory patients undergoing orthopedic surgery on an extremity. Study subjects completed three unattended home sleep apnea tests: baseline before surgery, the first night after surgery (N1), and third night after surgery (N3)...
March 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29600254/anesthesiology-residency-curriculum-and-implementation-of-a-perioperative-surgical-home-curriculum-a-survey-study
#10
Joseph Rinehart, Jenny Seong, Navid Alem, Roberta Andreatta, Jason Derhovanesian, Christina Smith, Zeev Kain
Background: The perioperative surgical home (PSH) is a physician-led, interdisciplinary, and patient-centered model of perioperative care that focuses on patient outcomes and comprehensive care management. Many studies to date have looked at the clinical implementation of varied PSH models with promising results discussed. There are no studies directly examining concrete plans for the various Accreditation Council for Graduate Medical Education (ACGME) anesthesiology residency programs to implement augmented PSH training into curricula...
July 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29552519/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-for-staging-of-non-small-cell-lung-cancer
#11
Habiba Hashimi, David T Cooke, Elizabeth A David, Lisa M Brown
Accurate staging for non-small cell lung cancer (NSCLC) is essential to guide therapy. While computed tomography (CT) and positron emission tomography (PET) scan can indicate whether mediastinal lymphadenopathy is present, histologic confirmation is required to complete the staging evaluation. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique associated with similar diagnostic yield and improved postoperative pain and complication rates compared to mediastinoscopy...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29543640/anesthesia-for-percutaneous-pulmonary-valve-implantation-a-case-series
#12
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29530770/enhanced-recovery-decreases-pulmonary-and-cardiac-complications-following-thoracotomy-for-lung-cancer
#13
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29514558/perioperative-surgical-home-reduces-rapid-response-calls-to-a-postoperative-surgical-ward-how-anesthesiologists-are-improving-the-inpatient-safety-net
#14
Tessa L Walters, T Edward Kim, Edward R Mariano, Geoffrey Kenton Lighthall
BACKGROUND: The Perioperative Surgical Home (PSH) is an anesthesiologist-led, coordinated care model that may improve patient experience and safety. We hypothesized that PSH will decrease activation of the rapid response system for surgical inpatients. METHODS: This retrospective study was performed at an academic Veterans Affairs hospital with a PSH. Data from both medical and surgical cohorts admitted to a single ward were analyzed for the Pre-PSH (July 2006 to October 2010) and Post-PSH (November 2011 to May 2015) epochs...
March 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29505452/questions-regarding-perioperative-surgical-home-by-kim-et-al
#15
Matthew E Oetgen, Janish Jay Patel, Eugenie Heitmiller, Sophie Pestieau
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29443839/how-common-and-how-serious-is-clostridium-difficile-colitis-after-geriatric-hip-fracture-findings-from-the-nsqip-dataset
#16
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29394733/-surgical-treatment-for-extremely-elderly-patients-over-90-years-of-age-with-stage-iv-colorectal-cancer-a-report-of-four-cases
#17
Tetsunori Yoshimura, Eisuke Yamamoto, Sakiko Yabe, Taiki Masuda, Hitoshi Sugimoto, Haruya Koshiishi
We report 4 cases ofStage IV colorectal cancer patients over 90 years ofage who received surgical treatment. All of 4 cases were right-sided advanced colon cancer(1 case had also recto-sigmoid advanced cancer)and were received emergency operation. Two cases received resection ofprimary tumors and anastomosis, the other 2 cases received only ileostomy or colostomy. Three cases were able to be discharged from hospital successfully, but unfortunately, we lost one case because of cerebrovascular complication after surgery...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29362043/obstructive-sleep-apnea-emphasis-on-discharge-education-after-surgery
#18
Arbert Nazareno, Cresilda Newsom, Esther Lee, Joseph Burkard
In the United States, the prevalence of obstructive sleep apnea (OSA) in the adult population is increasing. More than half of the surgical patients with OSA are predisposed to increased incidence of perioperative complications. Based on the recent evidence, obstructive events are at the highest on the third day after surgery, which predisposes them for postoperative complications. The American Society of Perianesthesia Nurses recommends that discharge education on OSA should be provided after surgery to patients diagnosed with OSA to promote continuous positive airway pressure (CPAP) compliance and self-care behaviors at home...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29332428/the-effectiveness-of-preoperative-preparation-for-improving-perioperative-outcomes-in-children-and-caregivers
#19
Chia-Jung Lin, Hsin-Ping Liu, Pei-Ya Wang, Mei-Hua Yu, Mei-Chun Lu, Ling-Yu Hsieh, Tzu-Chia Lin
Most children experience significant anxiety during the preoperative period. Greater preoperative anxiety may be related to a higher incidence of negative behaviors. This study aimed to develop a family-centered preoperative preparation program and to evaluate the effects of this program on children's preoperative emotional behaviors, postoperative behavior, and posthospital behavior, and on caregiver anxiety. A prospective, randomized controlled study was conducted. The population consisted of children who underwent minor surgery and their caregivers...
January 1, 2018: Behavior Modification
https://www.readbyqxmd.com/read/29328762/patients-experiences-with-at-home-preoperative-skin-disinfection-before-elective-hip-replacement-surgery
#20
Maria Qvistgaard, Sofia Almerud Österberg, Kristiina Heikkilä, Ann-Britt Thorén, Jenny Lovebo
The aim of the study was to describe patients' experiences with preoperative skin disinfection carried out in their home before elective hip replacement surgery with the aim of lowering the microbial burden and avoiding surgical site infections. The literature was reviewed for relevant studies. Optimal preparations before surgery depend on patients being able to assimilate preoperative information and instructions. The study was based on 14 interviews with patients who had undergone elective hip replacement surgery...
July 2017: Journal of Perioperative Practice
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