Editor's Note The Perioperative Surgical Home (PSH) model of care was successful in improving quality of care and outcomes in elderly hip fracture patients and children having cardiac surgery in two studies presented October 14 at the Anesthesiology 2018 annual meeting in San Francisco. One study compared 308 hip fracture…

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Editor's Note In this study, the composition of the anesthesia care team (anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was not associated with any significant differences in mortality, length of stay, or inpatient spending. Of 443,098 Medicare beneficiaries who had inpatient surgery between 2004 and 2011, the adjusted mortality for…

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Editor's Note The Society of Anesthesia and Sleep Medicine (SASM) has issued a new guideline on Intraoperative Management of Adult Patients with Obstructive Sleep Apnea (OSA). Specific aims of the guideline are to: evaluate considerations of difficult airway management in patients with OSA assess the impact of anesthesia-related drugs and…

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Editor's Note In patients with American Society of Anesthesiologists physical status I and II, the risk of 30-day morbidity and mortality was similar for those who had blood testing shortly before surgery and those whose testing was done up to 2 months before surgery, this study finds. Of 235,010 patients…

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Editor's Note In cardiac surgery patients at moderate-to-high risk for death, a restrictive strategy for red blood cell (RBC) transfusion was equivalent to a liberal strategy, with respect to death from any cause, myocardial infarction, stroke, or renal failure, at 6-months follow-up, this study finds. There also were no significant…

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Editor's Note In this study, no benefit of hypnosis before general anesthesia was found on postoperative pain, but it had other benefits, such as less fatigue and anxiety (especially in patients who thought they received hypnosis, but did not) and higher patient satisfaction scores. A total of 150 women having…

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Editor's Note A blood management program at Johns Hopkins using a hemoglobin transfusion threshold of 7 g/dl in orthopedic surgical patients reduced blood use by 32.5% and resulted in similar or improved outcomes. Improved outcomes were primarily in patients 65 years of age or older. For this study, researchers evaluated…

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Editor's Note Increased use of neuraxial anesthesia was associated with lower hospitalization costs for hip and knee replacements, but more studies are needed before considering neuraxial anesthesia as a marker of quality, this study finds. National data on 808,237 total knee and 371,607 total hip replacements were analyzed. Increasing frequency…

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Editor's Note Limiting the level of sedation in elderly hip fracture patients with low comorbid states (Charlson comorbidity index [CCI] of 0) reduced postoperative delirium in this study. Of 200 elderly patients analyzed (100 in lighter sedation and 100 in heavier sedation levels), there was no statistically significant difference in…

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Editor's Note In adults more than 70 years of age, exposure to general anesthesia and surgery was associated with a subtle decline in memory and thinking skills in this study. Of 1,819 patients in the Mayo Clinic Study of Aging, exposure to anesthesia after age 70 was linked to long-term…

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