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Perioperative surgical home

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https://www.readbyqxmd.com/read/28925860/pharmacologic-and-perioperative-considerations-for-antihypertensive-medications
#1
Sher-Lu Pai, Ryan M Chadha, Joan M Irizarry Alvarado, Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: As the prevalence of hypertension continues to increase, physicians routinely encounter patients preoperatively receiving one or more cardiovascular medications to manage hypertension. Thus, the physician's knowledge of perioperative antihypertensive medication management is crucial to ensure patient safety. OBJECTIVE: We discuss the decisions to continue or stop antihypertensive medications to reduce the risk of perioperative complications. METHOD: We conducted a review of the original research studies, review articles, and editorials present on PubMed within the past 60 years...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925332/spine-deformity-surgery-in-the-elderly-risk-factors-and-30-day-outcomes-are-comparable-in-posterior-versus-combined-approaches
#2
John K Yue, David C Sing, Sourabh Sharma, Pavan S Upadhyayula, Ethan A Winkler, Jeremy D Shaw, Lionel N Metz
Objectives Risk factors portending poor outcome following elective spine deformity fusion remain in need of characterization and stratification in the elderly population. Methods Cases aged ≥60 years who underwent elective posterior or anterior-posterior ('combined') fusion were extracted from the American College of Surgeons National Surgical Quality Improvement Program years 2007-2013 and analyzed by surgical cohort (posterior vs. combined). The 30-day outcomes included operation time, hospital length of stay (HLOS), perioperative complications, and discharge destination...
September 19, 2017: Neurological Research
https://www.readbyqxmd.com/read/28922214/a-home-for-surgical-pain-management-the-perioperative-pain-service
#3
Jonathan P Wanderer, Naveen Nathan
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28914703/length-of-catheter-use-after-hysterectomy-as-a-risk-factor-for-urinary-tract-infection
#4
Natalie E Karp, Emily K Kobernik, Neil S Kamdar, Amanda M Fore, Daniel M Morgan
OBJECTIVES: The aims of this study were to determine the effect of length of postoperative catheterization on risk of urinary tract infection (UTI) and to identify risk factors for postoperative UTI. METHODS: This was a retrospective case-control study. Demographic and perioperative data, including duration of indwelling catheter use and postoperative occurrence of UTI within 30 days of surgery, were analyzed for hysterectomies using the Michigan Surgical Quality Collaborative database...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28913487/perioperative-surgical-home-meeting-tomorrow-s-challenges
#5
REVIEW
Teodora O Nicolescu
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28902101/early-ambulation-decreases-length-of-hospital-stay-perioperative-complications-and-improves-functional-outcomes-in-elderly-patients-undergoing-surgery-for-correction-of-adult-degenerative-scoliosis
#6
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos Bagley
STUDY DESIGN: Ambispective cohort review. OBJECTIVE: To examine the effects of early mobilization on patient outcomes, complications profile, and 30-day readmission rates. SUMMARY OF BACKGROUND DATA: Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. METHODS: We conducted an ambispective study of 125 elderly patients (>65 years) undergoing elective spinal surgery for correction of adult degenerative scoliosis...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28901987/enhanced-recovery-after-surgery-in-the-setting-of-the-perioperative-surgical-home
#7
Juhan Paiste, Jeffrey W Simmons, Thomas R Vetter
No abstract text is available yet for this article.
2017: International Anesthesiology Clinics
https://www.readbyqxmd.com/read/28888082/how-can-the-perioperative-surgical-home-be-applied-to-pediatric-anesthesia-practice
#8
EDITORIAL
Lynne R Ferrari
No abstract text is available yet for this article.
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28885096/infant-hydrocephalus-in-sub-saharan-africa-the-reality-on-the-tanzanian-side-of-the-lake
#9
Maria M Santos, Derick K Rubagumya, Imani Dominic, Amos Brighton, Soledad Colombe, Philip O'Donnell, Micaella R Zubkov, Roger Härtl
OBJECTIVE Infant hydrocephalus is estimated to affect more than 100,000 new infants each year in sub-Saharan Africa (SSA). Bugando Medical Centre (BMC), a government-funded and patient cost-shared referral center, serves over 13 million people in the Lake and Western regions of Tanzania. The goals of this study were to characterize the infant population affected by hydrocephalus who presented to BMC and were treated with a ventriculoperitoneal shunt (VPS) to determine the rate of early complications associated with this surgical procedure and to assess its potential risk factors...
September 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28865635/improving-efficiency-and-patient-experiences-the-perioperative-surgical-home-model
#10
Theresa Criscitelli
No abstract text is available yet for this article.
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#11
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28795967/the-perioperative-surgical-home-a-new-role-for-the-acute-pain-service
#12
Michael P Zaccagnino, Angela M Bader, Christine N Sang, Darin J Correll
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28778801/pre-operative-embolization-of-hypervascular-spinal-metastasis-using-percutaneous-direct-intra-tumoural-injection-with-onyx-under-local-anesthesia
#13
Kai-Zheong Lim, Tony Goldschlager, Ronil V Chandra
Intra-operative blood loss remains a major cause of perioperative morbidity for patients with hypervascular spinal metastasis undergoing surgery. Pre-operative embolization is used to reduce intraoperative blood loss and operative time. This is commonly performed under general anesthesia via a trans-arterial approach, which carries a risk of spinal stroke. We propose an alternative technique for embolization of hypervascular metastases using the Onyx embolic agent via a percutaneous direct intra-tumoural injection under local anesthesia and sedation to reduce embolization risks and procedure time, as well as operative blood loss and operative time...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28760151/pureair-protocol-randomized-controlled-trial-of-intensive-pulmonary-rehabilitation-versus-standard-care-in-patients-undergoing-surgical-resection-for-lung-cancer
#14
Stefania Fugazzaro, Stefania Costi, Carlotta Mainini, Besa Kopliku, Cristian Rapicetta, Roberto Piro, Roberta Bardelli, Patricia Filipa Sobral Rebelo, Carla Galeone, Giorgio Sgarbi, Filippo Lococo, Massimiliano Paci, Tommaso Ricchetti, Silvio Cavuto, Domenico Franco Merlo, Sara Tenconi
BACKGROUND: Non-small cell lung cancer is the most common type of lung cancer. Surgery is proven to be the most effective treatment in early stages, despite its potential impact on quality of life. Pulmonary rehabilitation, either before or after surgery, is associated with reduced morbidity related symptoms and improved exercise capacity, lung function and quality of life. METHODS: We describe the study protocol for the open-label randomized controlled trial we are conducting on patients affected by primary lung cancer (stages I-II) eligible for surgical treatment...
July 31, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#15
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28733750/magnetic-surgery-first-u-s-experience-with-a-novel-device
#16
Ivy N Haskins, Andrew T Strong, Matthew T Allemang, Kalman P Bencsath, John H Rodriguez, Matthew D Kroh
INTRODUCTION: Magnet-assisted surgery is a new platform within minimally invasive surgery. The Levita™ Magnetic Surgical System, the first magnetic surgical system to receive Food and Drug Administration (FDA) approval, includes a deployable, magnetic grasper and an external magnet that is used to manipulate the grasper within the peritoneal cavity. This system is currently approved for patients undergoing laparoscopic cholecystectomy with a body mass index (BMI) between 21 and 34 kg/m(2)...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28731875/management-of-complex-spine-surgery
#17
Massimo Lamperti, Boris Tufegdzic, Rafi Avitsian
PURPOSE OF REVIEW: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. RECENT FINDINGS: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery...
October 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28709946/frailty-and-sarcopenia-do-not-predict-adverse-events-in-an-elderly-population-undergoing-non-complex-primary-elective-surgery-for-degenerative-conditions-of-the-lumbar-spine
#18
Raphaële Charest-Morin, John Street, Honglin Zhang, Taren Roughead, Tamir Ailon, Michael Boyd, Marcel Dvorak, Brian Kwon, Scott Paquette, Nicolas Dea, Charles G Fisher, Alana M Flexman
BACKGROUND CONTEXT: Sarcopenia measured by normalized total psoas area (NTPA) has been shown to predict mortality and adverse events (AEs) in numerous surgical populations. The relationship between sarcopenia and postoperative outcomes after surgery for degenerative spine disease (DSD) has not been investigated. PURPOSE: This study aimed to determine the relationships between sarcopenia, frailty, and postoperative AEs in the elderly DSD population. Secondary objectives were to describe the distribution and predictors of NTPA and to determine the relationship between sarcopenia, frailty, and length of stay, discharge to a facility, and in-hospital mortality...
July 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28694151/liposomal-bupivacaine-decreases-pain-following-retropubic-sling-placement-a-randomized-placebo-controlled-trial
#19
Donna Mazloomdoost, Rachel N Pauls, Erin N Hennen, Jennifer Y Yeung, Benjamin C Smith, Steven D Kleeman, Catrina C Crisp
BACKGROUND: Midurethral slings are commonly used to treat stress urinary incontinence. Pain control, however, may be a concern. Liposomal bupivacaine is a local anesthetic with slow release over 72 hours, demonstrated to lower pain scores and decrease narcotic use postoperatively. OBJECTIVE: The purpose of this study was to examine the impact of liposomal bupivacaine on pain scores and narcotic consumption following retropubic midurethral sling placement. STUDY DESIGN: This randomized, placebo-controlled trial enrolled women undergoing retropubic midurethral sling procedures with or without concomitant anterior or urethrocele repair...
July 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28673707/predictors-of-survival-functional-survival-and-hospital-readmission-in-octogenarians-after-surgical-aortic-valve-replacement
#20
Kendra Kuo, Pallav Shah, Brett Hiebert, Karin Love, Alan H Menkis, Rizwan A Manji, Rakesh C Arora
OBJECTIVE: To analyze outcomes and predictors of functional survival (personal care home admission and mortality) and hospital readmission in patients aged ≥80 years who underwent surgical aortic valve replacement (SAVR) in a Manitoba hospital. METHODS: This was a retrospective cohort study of patients aged ≥80 years who underwent SAVR with or without coronary artery bypass grafting in Manitoba between 1995 and 2014. Data from the Manitoba Adult Cardiac Surgery database and the Manitoba Centre for Health Policy were used...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
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