Article
Medicine, General & Internal
Xiaopeng Guo, Duoxing Zhang, Haiyu Pang, Zihao Wang, Lu Gao, Yu Wang, Wenbin Ma, Wei Lian, Bing Xing
Summary: This study demonstrates that withholding hydrocortisone during pituitary adenoma surgery is safe for patients with an intact HPA axis, and the incidence of new-onset adrenal insufficiency is noninferior to the conventional supplementation regimen.
Article
Multidisciplinary Sciences
Nicole Lange, Thomas Stadtmueller, Stefanie Scheibel, Gerda Reischer, Arthur Wagner, Bernhard Meyer, Jens Gempt
Summary: A prospective study was conducted on patients undergoing spinal surgery, revealing a high postoperative complication rate, especially in patients with metastatic tumors and poor clinical status. Age-adjusted CCI, metastatic tumor, atrial fibrillation, postoperative KPS, postoperative anemia, length of hospital stay, and duration of surgery were identified as significant risk factors for postoperative complications.
SCIENTIFIC REPORTS
(2022)
Article
Multidisciplinary Sciences
Yawen Zhang, Xiangjie Fu, Xi Xie, Danyang Yan, Yanjie Wang, Wanting Huang, Run Yao, Ning Li
Summary: A predictive model for perioperative blood transfusion risk was established using a nomogram, which included 8 predictive factors. The model showed good performance in both the derivation and validation cohorts.
SCIENTIFIC REPORTS
(2022)
Article
Medicine, General & Internal
Shin-ichi Yamada, Kazuyuki Koike, Emiko Tanaka Isomura, Daichi Chikazu, Kenji Yamagata, Masahiro Iikubo, Satoshi Hino, Hideharu Hibi, Kouji Katsura, Seiji Nakamura, Takeshi Nomura, Yoshiyuki Mori, Itaru Tojyo, Narisato Kanamura, Iku Yamamori, Keiko Aota, Shigeyuki Fujita, Hideki Tanzawa, Hiroshi Kurita
Summary: The study aimed to investigate the efficacy of perioperative oral managements (POMs) on perioperative nutritional conditions in patients undergoing surgery with general anesthesia. Through a multicenter analysis based on a large number of cases, it was found that POMs had a significant positive effect on serum albumin levels. Other significant predictors included patient gender, age, surgical site, ASA classification, operation time, and amount of blood loss. Adjusted multivariate analysis also confirmed the positive effects of POMs on serum albumin levels.
Article
Clinical Neurology
Liqi Shu, Wei Jiang, Han Xiao, Nils Henninger, Thanh N. Nguyen, James E. Siegler, Adam de Havenon, Eric D. Goldstein, Daniel Mandel, Maheen Rana, Fawaz Al-Mufti, Jennifer Frontera, Karen Furie, Shadi Yaghi
Summary: This study aimed to determine the risk factors of acute ischemic stroke (AIS) during the periprocedural period in patients with atrial fibrillation (AF). The results showed that higher CHA(2)DS(2)VASc scores, cardiovascular surgery, neurological surgery, and active cancer were associated with an increased risk of periprocedural AIS.
ANNALS OF NEUROLOGY
(2023)
Article
Medicine, General & Internal
Joseph Alderman, Amit Sharma, Jaimin Patel, Fang Gao-Smith, Ciro Morgese
Summary: The study aimed to investigate the use of intrathecal diamorphine as analgesia for major elective laparoscopic colorectal surgery in the UK. The results showed that a high percentage of consultant anaesthetists used intrathecal opioids routinely, with diamorphine being the most commonly used drug. However, there was a lack of consensus regarding the optimal dosing of intrathecal diamorphine. Further randomized dose-response trials are needed to understand the relationship between the dose of intrathecal diamorphine and patient outcomes.
Review
Cardiac & Cardiovascular Systems
Ajay Kumar Jha, Nivedita Jha, Vishwas Malik
Summary: Pulmonary hypertension (PH) is a manifestation of both cardiorespiratory and non-cardiorespiratory pathologies, with cardiorespiratory pathologies accounting for the majority of cases. Increasing recognition of PH in the perioperative setting has led to a greater understanding of the risks it poses. However, the importance of PH in perioperative decision-making and outcomes is often overlooked in guidelines. Understanding the complexity of PH physiology can assist in making informed anaesthetic and surgical decisions.
HEART LUNG AND CIRCULATION
(2023)
Article
Orthopedics
Elaine Z. Shing, Daniel Leas, Caleb Michalek, Meghan K. Wally, Nady Hamid
Summary: The study aims to develop and test an opioid-free perioperative analgesic pathway for patients undergoing common elective orthopedic procedures. The primary outcome measure is pain score at 24h postoperatively, with secondary outcomes including pain scores at additional time points, medication side effects, and patient-reported variables. The ultimate goal is to help reduce the impact of prescription opioids on the national opioid crisis.
BMC MUSCULOSKELETAL DISORDERS
(2021)
Article
Medicine, General & Internal
Giuseppe Pascarella, Fabio Costa, Giulia Nonnis, Alessandro Strumia, Domenico Sarubbi, Lorenzo Schiavoni, Annalaura Di Pumpo, Lara Mortini, Stefania Grande, Andrea Attanasio, Giovanni Gadotti, Alessandro De Cassai, Alessia Mattei, Antonio Nenna, Massimo Chello, Rita Cataldo, Felice Eugenio Agro, Massimiliano Carassiti
Summary: Ultrasound guided parasternal block is an effective technique for managing postoperative analgesia and reducing opioid consumption in patients undergoing cardiac surgery. Compared to the control group, the parasternal group had lower intraoperative opioid consumption, shorter extubation times, and better postoperative performance at spirometry.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Multidisciplinary Sciences
Jung Hee Kim, Hyung-Chul Lee, Su-jin Kim, Soo Bin Yoon, Sung Hye Kong, Hyeong Won Yu, Young Jun Chai, June Young Choi, Kyu Eun Lee, Kwang-Woong Lee, Seung-Kee Min, Chan Soo Shin, Kyu Joo Park
Summary: Surgery for PPGL can be curative, but the perioperative period poses challenges due to the risk of hemodynamic instability. Factors such as duration of alpha-adrenergic receptor blocker use, urine epinephrine levels, and preoperative heart rate can predict intraoperative and postoperative hemodynamic instability in PPGL patients, requiring caution in perioperative management.
SCIENTIFIC REPORTS
(2021)
Review
Surgery
Meghan Brennan, Jack D. Hagan, Chris Giordano, Tyler J. Loftus, Catherine E. Price, Haldun Aytug, Patrick J. Tighe
Summary: Physicians use perioperative decision-support tools to mitigate risks and maximize benefits. Contemporary risk-assessment practices augment surgeons' judgement and experience with decision-support algorithms driven by big data and machine learning.
Review
Endocrinology & Metabolism
Ursula Galway, Praveen Chahar, Marc T. Schmidt, Jorge A. Araujo-Duran, Jeevan Shivakumar, Alparslan Turan, Kurt Ruetzler
Summary: Prediabetes and diabetes have significant perioperative implications, making careful preoperative evaluation crucial in reducing risks and improving outcomes during surgery.
WORLD JOURNAL OF DIABETES
(2021)
Article
Surgery
Chul Seung Lee, Soo Ji Park, Sang Hyun Hong, Jung-Woo Shim, Min Suk Chae, Seung-Rim Han, Jung Hoon Bae, In Kyu Lee, Dosang Lee, Yoon Suk Lee, Seong Taek Oh
Summary: The study showed that implementing a multimodal perioperative pain management protocol significantly reduced postoperative pain and shortened the length of postoperative hospital stays for minimally invasive colorectal cancer surgery.
ASIAN JOURNAL OF SURGERY
(2021)
Article
Anesthesiology
Xavier Capdevila, Sigismond Lasocki, Alexis Duchalais, Jean-Christophe Rigal, Patrice Mertl, Pierre Ghewy, Frederic Farizon, Thomas Lanz, Axel Buckert, Samia Belarbia, Jean-Noel Trochu, Patrice Cacoub
Summary: This study aimed to update the prevalence data of iron deficiency in French patients scheduled for major surgery, revealing that half of the patients had iron deficiency but few relevant treatments were implemented preoperatively or postoperatively. Actions, including better patient blood management, are urgently needed to improve these outcomes.
ANESTHESIA AND ANALGESIA
(2023)
Review
Anesthesiology
Kamal Maheshwari, Jacek B. Cywinski, Frank Papay, Ashish K. Khanna, Piyush Mathur
Summary: The role of anesthesiologists has expanded to provide coordinated care throughout the surgical experience. Rapid advances in technologies like artificial intelligence offer opportunities to enhance perioperative medicine, improve patient safety, and optimize cost of care. This review discusses specific applications of artificial intelligence in perioperative medicine and provides recommendations for successful adoption.
ANESTHESIA AND ANALGESIA
(2023)