-
Anesthesia and Analgesia Dec 2022
Topics: Preoperative Care; Proof of Concept Study
PubMed: 36384012
DOI: 10.1213/ANE.0000000000006193 -
JAMA Nov 2022
Topics: Humans; Kidney Failure, Chronic; Renal Dialysis; Preoperative Care; Time Factors
PubMed: 36326729
DOI: 10.1001/jama.2022.19442 -
Anesthesiology Sep 2020
Review
Topics: Anesthesiologists; Anesthesiology; Enhanced Recovery After Surgery; Humans; Patient Compliance; Preoperative Care
PubMed: 32358253
DOI: 10.1097/ALN.0000000000003331 -
Neurosurgery Clinics of North America Jul 2020The past decade has seen a significant shift in the number of centers performing intracranial electroencephalography from subdural grids and strips to... (Review)
Review
The past decade has seen a significant shift in the number of centers performing intracranial electroencephalography from subdural grids and strips to stereoelectroencephalography (SEEG). Unlike grid and strip insertion or other stereotactic procedures in which the cortical surface is visualized, SEEG involves insertion of an electrode through a bolt anchored into the skull. Due to the multidisciplinary nature of SEEG trajectory planning, it often is time-consuming and iterative. Computer-assisted planning improves time taken and efficacy of SEEG trajectory planning. This article provides an overview of the considerations, controversies, and practicalities of implementing an automated computer-assisted planning solution for SEEG planning.
Topics: Electrodes, Implanted; Electroencephalography; Epilepsy; Humans; Neurosurgical Procedures; Preoperative Care; Stereotaxic Techniques; Surgery, Computer-Assisted
PubMed: 32475489
DOI: 10.1016/j.nec.2020.03.005 -
PM & R : the Journal of Injury,... Oct 2023We aimed to identify and describe the current interventions used in preoperative programs ("prehabilitation") for spine surgery. Knowledge gaps in approaches,... (Review)
Review
We aimed to identify and describe the current interventions used in preoperative programs ("prehabilitation") for spine surgery. Knowledge gaps in approaches, feasibility, timing, patient experience, clinical outcomes, and health care costs were explored while describing their potential benefits on physical and psychological outcomes. An electronic search was conducted from January 2004 to February 2022 in Ovid Medline, Embase, EBSCO CINAHL, the Cochrane Database of Systematic Reviews, and PEDro to identify studies in English evaluating adults enrolled in prehabilitation before undergoing elective spine surgeries. Studies were uploaded into DistillerSR for systematic screening after removing duplicates. Four reviewers screened nested references for inclusion based on titles and abstracts, followed by their full-text review. Two reviewers subsequently extracted data and summarized the results. The results were reported using Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Studies were rated for quality using National Health and Medical Research Council criteria. Out of 18,879 potential studies, a total of 23 studies (0.12%) met the eligibility criteria and were included in this scoping review. The prehabilitation programs included general education (n = 6, 26%), exercise (n = 6, 26%), cognitive behavioral therapy (n = 3, 13%), pain neuroscience education (n = 3, 13%), health behavior counseling (n = 3, 13%), and mindfulness (n = 2, 9%). Additional studies are needed to identify optimal patient characteristics, intervention dosage, and whether multimodal approaches using a combination of physical and psychological strategies lead to more favorable outcomes. Although studies on prehabilitation for spine surgery are limited, they seem to demonstrate that prehabilitation programs are feasible, reduce medical expenditures, and improve patients' postoperative pain, disability, self-efficacy, psychological behaviors, and satisfaction with surgical outcomes. The available literature suggests there is an opportunity to improve patient experience, clinical outcomes and reduce medical costs with the use of prehabilitation in spine surgery.
Topics: Adult; Humans; Preoperative Exercise; Preoperative Care; Exercise; Pain, Postoperative
PubMed: 36730164
DOI: 10.1002/pmrj.12956 -
Best Practice & Research. Clinical... May 2021Preoperative risk evaluation scores are used prior to surgery to predict perioperative risks. They are also a useful tool to help clinicians communicate the risk-benefit... (Review)
Review
Preoperative risk evaluation scores are used prior to surgery to predict perioperative risks. They are also a useful tool to help clinicians communicate the risk-benefit balance of the procedure to patients. This review identifies and assesses the existing preoperative risk evaluation scores (also called prediction scores) of postoperative mortality in all types of surgery (emergency or scheduled) in an adult population. We systematically identified studies using the MEDLINE, Ovid EMBASE and Cochrane databases and published studies reporting the development and validation of preoperative predictive scores of postoperative mortality. We assessed usability, the level of evidence of the studies performed for external validation, and the predictive accuracy of the scores identified. We found 26 scores described within 60 different reports. The most suitable scores with the highest validity identified for anaesthesia practice were the Preoperative Score to Predict Postoperative Mortality (POSPOM), the Universal ACS NSQIP surgical risk calculator (ACS-NSQUIP), the Clinical Frailty Scale (CFS) and the American Society of Anesthesiologists Physical Status (ASA-PS) classification system. While other scores identified in this review could also be endorsed, their level of validity and generalizability to the general surgical population should be carefully considered.
Topics: Anesthesia Recovery Period; Humans; Mortality; Postoperative Complications; Preoperative Care; Risk Assessment; Risk Factors
PubMed: 33742572
DOI: 10.1016/j.bpa.2020.12.005 -
Nursing Standard (Royal College of... Dec 2020Preoperative care refers to the physical and psychosocial care that prepares a patient to undergo surgery safely. The preoperative period begins when the patient is...
UNLABELLED
Preoperative care refers to the physical and psychosocial care that prepares a patient to undergo surgery safely. The preoperative period begins when the patient is booked for surgery and ends with their transfer to the theatre or surgical suite. As well as the preoperative care that takes place in hospital, various preoperative tests and clinical assessments can be undertaken during a preoperative outpatient appointment, one week or more before surgery takes place. Patient information will also be provided at this time. These outpatient appointments are often led by nurse specialists or advanced nurse practitioners and may involve remote consultations via telephone or email. All nurses involved in the care of patients undergoing surgery should.
REFLECTIVE ACTIVITY
'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: •How this article can improve your practice when supporting patients who are undergoing preoperative care.•How you could use this article to educate your colleagues on the principles of preoperative care.
Topics: Humans; Preoperative Care; Writing
PubMed: 33252202
DOI: 10.7748/ns.2020.e11657 -
The British Journal of Surgery Feb 2020An analysis of the results and conclusions from the most recent RCTs of the role of mechanical bowel preparation before colonic surgery is presented. The results... (Review)
Review
An analysis of the results and conclusions from the most recent RCTs of the role of mechanical bowel preparation before colonic surgery is presented. The results indicate a wide disparity in the methods, results and conclusion of these studies, and the lack of microbial culture confirmation to advance understanding of how to move the field forward. Controversy on bowel preparation in colorectal surgery.
Topics: Colon; Colorectal Surgery; Digestive System Surgical Procedures; Elective Surgical Procedures; Humans; Preoperative Care
PubMed: 31872429
DOI: 10.1002/bjs.11454 -
Best Practice & Research. Clinical... Jun 2020Preoperative laboratory testing is often necessary and can be invaluable for diagnosis, assessment, and treatment. However, performing routine laboratory tests for... (Review)
Review
Preoperative laboratory testing is often necessary and can be invaluable for diagnosis, assessment, and treatment. However, performing routine laboratory tests for patients who are considered otherwise healthy is not usually beneficial and is costly. It is estimated that $18 billion (U.S.) is spent annually on preoperative testing, although how much is wasteful remains unknown. Ideally, a targeted and comprehensive patient history and physical exam should largely determine whether preprocedure laboratory studies should be obtained. Healthcare providers, primarily anesthesiologists, should remain cost-conscious when ordering specific laboratory or imaging tests prior to surgery based on available literature. We review the overall evidence and key points from the Choosing Wisely guidelines, the identification of potential wasteful practices, possible harms of testing, and key clinical findings associated with preoperative laboratory testing.
Topics: Cross-Sectional Studies; Diagnostic Tests, Routine; Humans; Practice Guidelines as Topic; Preoperative Care; Retrospective Studies; Societies, Medical
PubMed: 32711836
DOI: 10.1016/j.bpa.2020.04.006 -
Annals of the Academy of Medicine,... Nov 2019As the world's population ages rapidly, many elderly people are living to a much more advanced age than before. Consequently, medical conditions that require surgical... (Review)
Review
As the world's population ages rapidly, many elderly people are living to a much more advanced age than before. Consequently, medical conditions that require surgical interventions such as solid organ cancers are also getting more common. While young and fit patients may be able to withstand surgical stresses and recover rapidly after operation, older adults may find these challenging. Rehabilitation that is instituted in the postoperative period aims to help patients regain physical fitness and robustness to preoperative levels. However, recent studies have shown that prehabilitation may be more effective in bringing the fitness level of elderly patients to a higher level before they go for surgery. There are many controversies regarding the effectiveness of prehabilitation, the components of this intervention-be it mono- or multimodalities-and the duration of prehabilitation. This paper looks at the current evidence of this hot topic revolving geriatric surgery.
Topics: Aged; Exercise Therapy; Frailty; Humans; Nutritional Support; Postoperative Complications; Preoperative Care; Surgical Procedures, Operative
PubMed: 31960020
DOI: No ID Found