Tag: Preoperative Care

Superior patient-centered care crucial for complex outpatient procedures

About 2 years ago I was diagnosed with prostate cancer. As I researched the treatment alternatives, I became very concerned about the complications associated with traditional surgical prostatectomy or radiation. Then I learned that I might be eligible for an outpatient procedure: high-intensity focused ultrasound (HIFU). Although HIFU is relatively…

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By: OR Manager
September 23, 2019
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Music reduces anxiety before regional anesthesia

Editor's Note Music is a viable alternative to IV midazolam in reducing anxiety before a preoperative peripheral nerve block, this study finds. A total of 157 adult patients were randomly assigned to one of two options 3 minutes before peripheral nerve block−either an injection of 1-2 mg of midazolam or…

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By: Judy Mathias
July 23, 2019
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Preop opioid, benzodiazepine use linked to postop mortality, opioid consumption

Editor's Note Use of opioids and benzodiazepines 6 months before surgery was associated with increased short- and long-term mortality and an increased rate of persistent postoperative opioid consumption, this study finds. In this analysis of 41,170 noncardiac surgical cases in 27,787 patients in Iceland, preoperative prescriptions for opioids only were…

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By: Judy Mathias
June 27, 2019
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AHRQ opens enrollment for hospitals to implement enhanced recovery pathways

Editor's Note The American College of Surgeons on June 6 called for interested hospitals to join a new cohort of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR). In the program, presented in collaboration with the Johns Hopkins Medicine Armstrong Institute…

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By: Judy Mathias
June 7, 2019
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OR leaders see benefits of briefer NPO period

Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations. In 1999, the American Society of Anesthesiologists (ASA) revised their fasting guidelines to clear liquids up to 2 hours before surgery and…

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By: Judith M. Mathias, MA, RN
May 17, 2019
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Adherence to ERAS protocols associated with fewer postop complications

Editor's Note An increased in adherence to Enhanced Recovery after Surgery (ERAS) protocols was associated with a decrease in postoperative complications in this study. Of 2,084 patients analyzed, 566 had moderate to severe postoperative complications. The number of patients with moderate to severe complications was lower in the ERAS group…

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By: Judy Mathias
May 13, 2019
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Patient, surgeon outcomes reporting app helps predict success of ventral hernia repair

Editor's Note Researchers have developed an online app that patients and surgeons can use to guide preoperative planning and provide predictive data for how a patient’s ventral hernia repair will turn out. The basis of the app is a tool named the “Outcomes Reporting App for CLinical and Patient Engagement”…

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By: Judy Mathias
May 8, 2019
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Intervention to reduce low-value preop tests before cataract surgery

Editor's Note Reducing low-value testing before cataract surgery was associated with cost savings for financially capitated healthcare systems, but it was also associated with losses for fee-for-service healthcare systems, which could be a barrier to eliminating low-value care, this study finds. Of 1,054 patients (469 intervention, 585 controls) included in…

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By: Judy Mathias
May 7, 2019
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Preop functional status predicts total hip outcomes

Editor's Note Compared with preoperative independent functional status, preoperative dependent functional status was independently associated with worse outcomes after primary total hip arthroplasty in this study. Of 43,179 patients analyzed, those who were less able to care for themselves: were 2 to 3 times more likely to have surgical complications…

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By: Judy Mathias
April 23, 2019
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Factors linked to, lessons learned from reduced mortality during military conflicts

Editor's Note The increased use of tourniquets, blood transfusions, and reduced time to surgical treatment (ie, within 1 hour) were the main factors that reduced mortality 44.2% during military conflicts in Afghanistan and Iraq, this study finds. From October 2001 through December 2017, survival increase three-fold among the most critically…

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By: Judy Mathias
April 1, 2019
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