Editor's Note In this study, the use of preoperative and postoperative elements of a Perioperative Surgical Home model in total knee and hip patients was associated with improvements in operational outcomes. The study included 1,225 patients in a preintervention PSH group and 1,363 in a postintervention PSH group. Compared with…

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Editor's Note In this French study, the majority of ICU patients had at least one organ failure at the time of death. Of 698 patients analyzed, 84% had one or more organ failures and 89% required at least one organ support at the time of death. Deaths were considered unexpected…

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Editor's Note The combination of femoral and sciatic nerve blocks is the overall best approach to pain management after total knee arthroplasty, finds this meta-analysis. The best five modalities for pain at rest were: femoral/obturator, femoral/sciatic/obturator, lumbar plexus/sciatic, femoral/sciatic, and fascia iliaca compartment blocks. For reducing opioid consumption, the best…

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Editor's Note Conscious sedation is a safe and viable option for anesthesia in patients having transcatheter aortic valve replacement (TAVR), finds this study. The use of conscious sedation rather than general anesthesia was associated with: similar rates of adverse events (1.5% in both groups) shortened ICU (30 vs 96 hours)…

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Editor's Note Non-OR anesthesia (NORA) is a growing component of anesthesiology practice in the US, this study finds. The proportion of NORA cases overall increased from 28.3% in 2010 to 35.9% in 2014, and the proportion of NORA outpatient cases increased from 69.7% to 73.3%. Colonoscopy was the most common…

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Editor's Note For the National Patient Safety Foundation’s Patient Safety Awareness Week, March 12 to 18, certified registered nurse anesthetists (CRNAs) are urging surgical, obstetric, and chronic pain patients to learn about the risks and benefits of pain relief options available to them, including opioid and non-opioid treatments. Partnering with…

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Editor's Note Opting out of the Medicare rule that requires anesthesia to be administered with physician supervision has little or no effect on access to inpatient or outpatient surgery, this study finds. The researchers also found that opting out does not reduce costs, and in fact increases costs for inpatient…

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Editor's Note Implementation of a Perioperative Surgical Home (PSH) program for patients undergoing ambulatory laparoscopic cholecystectomy in a Kaiser Permanente practice model was associated with significantly reduced length of stay and unplanned hospital admission in this study. The analysis included 878 patients in the preimplementation period and 1,082 in the…

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Editor's Note In this study, Vanderbilt University Medical Center researchers created an automated system to identify diabetic patients, detect insulin administration, check for glucose measurement, and remind anesthesiologists to check intraoperative glucose. Implementation of the automated reminder system: improved glucose monitoring from 61.6% to 87.3% of cases reduced PACU hyperglycemia…

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Editor's Note Nerve blocks in total knee patients were associated with statistically significant reductions in length of stay and readmissions, but no difference in emergency department visits or in-hospital falls, this Canadian study finds. In the analysis of 178,214 patients, adjusted: mean hospital stay was 4.7 days for patients with…

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