Takeaways • Children are not small adults. Greater attention should be paid to their fears and anxiety, and equipment and medication should be tailored to meet their needs. • All staff should have Pediatric Advanced Life Support (PALS) certification. • ASCs can use toys and games as distractions to ease…

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Editor's Note The American Society of Anesthesiologists (ASA) has updated its 2017 guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration. The new 2023 guidance focuses on topics not addressed in the previous guideline, including ingestion of carbohydrate-containing clear liquids with or…

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Editor's Note This study by researchers at the Massachusetts General Hospital, Boston, finds that patients participating in an Enhanced Recovery after Surgery (ERAS) program were prescribed significantly fewer opioids at discharge, compared to patients before ERAS was instituted. A total of 3,983 patients were included (1,929 pre-ERAS and 2,054 post-ERAS).…

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Editor's Note This study from the University of Michigan, Ann Arbor, finds that the introduction and removal of Michigan’s executive order curtailing elective surgery during COVID-19 lagged behind the ramp-down and ramp-up of elective surgery volume. Hospitals had already achieved a 91.7% reduction in case volume before the executive order…

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Editor's Note This study, led by researchers at the University Medical Center Utrecht in the Netherlands, finds that a liberal preoperative fasting policy allowing adults scheduled for general anesthesia to drink clear fluids until arrival in the OR was associated with reduced fasting duration and improved patient well-being with regard…

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Navigating contracts with anesthesia when anesthesiology services are suffering from workforce shortages and high costs is often tricky and complex. The biggest mistake ambulatory surgery centers (ASCs) make is that they do not know what they want when entering a contract negotiation with an anesthesia provider. As a result, ASCs…

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Editor's Note This study from Vanderbilt University Medical Center, Nashville, Tennessee, finds that increased time from COVID-19 diagnosis to having a surgical procedure was linked to decreased odds of experiencing major postoperative cardiovascular (CV) complications. A total of 3,997 adult patients who had a previous diagnosis of COVID-19 and underwent…

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Editor's Note In this study, researchers from Yale School of Medicine, New Haven, Connecticut, find that mortality after major surgery is elevated in older adults who are frail or who have probable dementia. A total of 1,193 major surgical procedures in 992 Medicare beneficiaries were analyzed. Among the findings: Overall,…

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Editor's Note The Food and Drug Administration (FDA) on November 29 posted Exela Pharma Sciences’ expansion of its recall of Sodium Bicarbonate Injection, USP, 8.4%, 50 mEq/50 mL vial, 20-count carton. The product poses a safety concern because of vial breakage with flying glass when pressurized while preparing the product for…

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Editor's Note This prospective Danish study finds that transfer to a postanesthesia care unit (PACU) immediately after elective hip and knee arthroplasty might be unnecessary in low-risk patients. A total of 696 total knee (274), total hip (287), and unicompartmental knee (135) arthroplasty patients were analyzed. Of those, 307 bypassed…

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