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Perioperative 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/29691166/improved-perioperative-care-of-elective-joint-replacement-patients-the-impact-of-an-orthopedic-perioperative-hospitalist
#5
Steven J Fitzgerald, Terrence C Palmer, Matthew J Kraay
BACKGROUND: We developed an orthopedic hospitalist fellowship program for our total joint replacement program at a large urban academic medical center. The goal of the program was to improve patient outcomes, quality, and healthcare value through collaborative perioperative care and improved care coordination. This study evaluates the implementation and impact of our modified Hospitalist-Orthopaedic Team Co-management model on quality and performance metrics. METHODS: We reviewed our Quality Institute data using 3 databases for the 16 months before (PreOH) and 18 months after (PostOH) implementation...
March 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29690755/perioperative-surgical-home-a-new-scope-for-future-anesthesiology
#6
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
#7
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/29684374/single-center-experience-of-tracheobronchoplasty-for-tracheobronchomalacia-perioperative-outcomes
#8
Daniel H Buitrago, Adnan Majid, Daniel E Alape, Jennifer L Wilson, Mihir Parikh, Michael S Kent, Sidhu P Gangadharan
BACKGROUND: We aimed to present trends in practice as our experience has grown, and report the postoperative morbidity and its associated factors following tracheobronchoplasty. METHODS: Retrospective cohort study conducted in 161 patients who underwent tracheobronchoplasty from October 2002-September 2016. The main outcome was development of a postoperative complication within 30 days of surgery. Postoperative complication events were graded using the Clavien-Dindo system...
April 20, 2018: Annals of Thoracic Surgery
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
#9
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29665666/-early-results-of-fenestrated-endovascular-aortic-repair-for-the-treatment-of-patients-with-thoracoabdominal-pathologies
#10
J C Zhu, X C Dai, Y D Luo, H L Fan, Z Feng, Y W Zhang, F G Hu
Objective: To evaluate the early results of fenestrated endovascular aortic repair (FEVAR) using physician-modified stent grafts (PMSGs) for the treatment of patients with thoracoabdominal pathologies. Methods: Nineteen consecutive patients who underwent FEVAR using PMSGs between April 2012 and September 2017 were retrospectively reviewed. The modality of FEVAR technique was assessed, perioperative clinical data was recorded and the early results were evaluated. Results: Indications were thoracoabdominal aortic pathologies, including juxtarenal abdominal aortic aneurysm (JAAA) ( n =12), chronic thoracoabdominal aortic dissection with aneurysmal dilatation ( n =3), thoracoabdominal aortic aneurysm (TAAA) ( n =1), infrarenal AAA with an accessory renal artery in the segment of the aneurysmal neck ( n =2) and type Ⅰ endoleak after EVAR for AAA( n =1)...
March 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29661205/comparison-between-minimally-invasive-spine-stabilization-with-and-without-posterior-decompression-for-the-management-of-spinal-metastases-a-retrospective-cohort-study
#11
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Hirokatsu Sawada, Enshi Nakayama, Hirotoki Soma
BACKGROUND: Posterior decompression and stabilization plays significant roles in palliative surgery for metastatic spinal tumor. However, the indication for addition of posterior decompression have not been examined. The purpose of this study was to investigate a retrospective cohort of outcomes of metastatic spinal tumor treated with minimally invasive spine stabilization (MISt) with or without posterior decompression. METHODS: The subjects were 40 patients who underwent MISt using percutaneous pedicle screws for metastatic spinal tumor, including 20 patients treated with stabilization alone (group A) and 20 patients with added posterior decompression (group B)...
April 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29644911/perceived-doctor-patient-relationship-and-satisfaction-with-general-practitioner-care-in-older-persons-in-residential-homes
#12
Claudia S de Waard, Antonius J Poot, Wendy P J den Elzen, Annet W Wind, Monique A A Caljouw, Jacobijn Gussekloo
OBJECTIVE: Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their general practitioners (GPs). DESIGN: Cross-sectional survey. SUBJECTS AND SETTING: Older persons (n = 653, median age 87 years; 69...
April 12, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29644050/correction-to-american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#13
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
[This corrects the article DOI: 10.1186/s13741-017-0063-6.].
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29627391/chinese-expert-consensus-on-enhanced-recovery-after-hepatectomy-version-2017
#14
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
#15
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/29609527/the-differentially-expressed-circular-ribonucleic-acids-of-primary-hepatic-carcinoma-following-liver-transplantation-as-new-diagnostic-biomarkers-for-primary-hepatic-carcinoma
#16
Weiguo Sui, Qing Gan, Fuhua Liu, Huaizhou Chen, Junfu Liu, Yong Dai
Recent studies have shown that circular ribonucleic acids have differential expression in some diseases. This study compared the expression levels of five circular ribonucleic acids between patients of primary hepatic carcinoma following liver transplantation and healthy individuals for searching a new diagnostic biomarker about primary hepatic carcinoma. We chose differentially expressed targeted circular ribonucleic acids according to fold change ≥2.0 or ≤-2.0 between circular ribonucleic acids microarray of perioperative liver transplantation and normal controls...
April 2018: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/29600254/anesthesiology-residency-curriculum-and-implementation-of-a-perioperative-surgical-home-curriculum-a-survey-study
#17
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/29588123/home-health-services-are-not-required-for-select-total-hip-arthroplasty-candidates-assessment-and-supplementation-with-an-electronic-recovery-application
#18
Roy I Davidovitch, Afshin A Anoushiravani, James E Feng, Kevin K Chen, Raj Karia, Ran Schwarzkopf, Richard Iorio
BACKGROUND: At our institution, all postoperative total hip arthroplasty (THA) candidates have received home health services (HHS), consisting of visiting nurses, physical and occupational therapists. However, with a more technologically inclined patient population, electronic patient rehabilitation applications (EPRAs) can be used to deliver perioperative care at the comfort of the patient's home. The aim of this study is to investigate the clinical utility and economic burden associated with digital rehabilitation applications in primary THA recipients...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29576120/pattern-of-perioperative-gabapentinoid-use-and-risk-for-postoperative-naloxone-administration
#19
A Deljou, S J Hedrick, E R Portner, D R Schroeder, W M Hooten, J Sprung, T N Weingarten
BACKGROUND: Single preoperative gabapentinoid (gabapentin and pregabalin) administration has been associated with respiratory depression during Phase I anaesthesia recovery. In this study, we assess for associations between chronic (home) use and perioperative administration (preoperative and postoperative) of gabapentinoids, and risk for severe over-sedation or respiratory depression as inferred from the use of naloxone. METHODS: From 2011 to 2016, we identified patients undergoing general anaesthesia discharged to standard postoperative wards and administered naloxone within 48 h of surgery in a single centre...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29555546/specific-situations
#20
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
Ambulatory surgery can be carried out in diabetic patients. By using a strict organisational and technical approach, the risk of glycaemic imbalance is minimised, allowing the patients to return to their previous way of life more quickly. Taking into account the context of ambulatory surgery, with a same day discharge, the aims are to minimise the changes to antidiabetic treatment, to maintain adequate blood sugar control and to resume oral feeding as quickly as possible. The preoperative evaluation is the same as for a hospitalised patient and recent glycaemic control (HbA1c) is necessary...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
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