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Anesthesiology Sep 2020
Review
Topics: Anesthesiologists; Anesthesiology; Enhanced Recovery After Surgery; Humans; Patient Compliance; Preoperative Care
PubMed: 32358253
DOI: 10.1097/ALN.0000000000003331 -
Journal of Visceral Surgery Apr 2016Despite advances in surgical techniques, anesthesia and perioperative care, which became safer and accessible to a higher proportion of high-risk patients, major surgery... (Review)
Review
Despite advances in surgical techniques, anesthesia and perioperative care, which became safer and accessible to a higher proportion of high-risk patients, major surgery remains morbid with a lot of patients not recovering their previous capacity. Indeed surgery is a physiological stress and decreases functional capacity in the postoperative period. A "prehabilitation" program should increase functional capacity in anticipation of an upcoming stress. It should occur after the surgical consultation and before surgery, and is based on three components: physical care, nutritional support and psychological support, during 6 to 8 weeks. The aims of prehabilitation are to improve both nutritional status and pre- and postoperative fitness, and to reduce postoperative complications. Prehabilitation demonstrated benefit on postoperative complications in cardiovascular surgery but its benefit in digestive surgery is still unclear with contradictory results. The aim of this review was to summarize results of prehabilitation on the pre- and postoperative period and to determine its possible future in digestive surgery.
Topics: Digestive System Surgical Procedures; Humans; Nutritional Support; Patient Selection; Postoperative Complications; Preoperative Care; Social Support
PubMed: 26851994
DOI: 10.1016/j.jviscsurg.2016.01.001 -
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 -
Journal of General Internal Medicine Jul 2017Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid... (Review)
Review
Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.
Topics: Cataract; Cataract Extraction; Humans; Medical History Taking; Physical Examination; Preoperative Care
PubMed: 28321549
DOI: 10.1007/s11606-017-4043-9 -
Brazilian Journal of Anesthesiology... 2018Ultrasound has increasingly growing applications in anesthesia. This procedure has proven to be a novel, non-invasive and simple technique for the upper airway... (Review)
Review
Ultrasound has increasingly growing applications in anesthesia. This procedure has proven to be a novel, non-invasive and simple technique for the upper airway management, proving to be a useful tool, not only in the operating room but also in the intensive care unit and emergency department. Indeed, over the years mounting evidence has showed an increasing role of ultrasound in airway management. In this review, the authors will discuss the importance of ultrasound in the airway preoperative assessment as a way of detecting signs of difficult intubation or to define the type and/or size of the endotracheal tube as well as to help airway procedures such as endotracheal intubation, cricothyrotomy, percutaneous tracheal intubation, retrograde intubation as well as the criteria for extubation.
Topics: Airway Management; Humans; Intubation, Intratracheal; Preoperative Care; Ultrasonography
PubMed: 30245096
DOI: 10.1016/j.bjan.2018.06.014 -
Journal of Clinical Nursing Jul 2017To explore the issues and challenges of care transitions in the preoperative environment.
AIMS AND OBJECTIVES
To explore the issues and challenges of care transitions in the preoperative environment.
BACKGROUND
Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there.
DESIGN
Qualitative descriptive design was used.
METHODS
Semistructured interviews were conducted in a 975-bed academic medical centre.
RESULTS
A total of 30 providers and 10 preoperative patients participated. Themes that arose were as follows: (1) need for clarity of purpose of preoperative care, (2) care coordination, (3) interprofessional boundaries of care and (4) inadequate time and resources.
CONCLUSION
Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence postoperative patient outcomes.
RELEVANCE TO CLINICAL PRACTICE
Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes.
Topics: Academic Medical Centers; Adult; Female; Humans; Patient Care Team; Perioperative Care; Preoperative Care; Qualitative Research; Quality of Health Care; Time Factors; Transitional Care
PubMed: 27706872
DOI: 10.1111/jocn.13610 -
JNMA; Journal of the Nepal Medical... Oct 2022The overall outcome of the patient after any surgery is determined not only by the fineness of the surgical procedure but also by preoperative conditioning and... (Review)
Review
UNLABELLED
The overall outcome of the patient after any surgery is determined not only by the fineness of the surgical procedure but also by preoperative conditioning and postoperative care. Prehabilitation decreases the surgical stress response and increases the preparedness of the patient to undergo planned surgical insult. Preoperatively structured inspiratory muscle exercises, cardiopulmonary fitness program, and planned exercise program for muscles of limbs, back, abdomen, head, and neck allow an overall upliftment of the physiological capacity of the patient to better cope with the surgical stress. Optimization of dietary status by macronutrients, micronutrients, and the nutrients has an impact on augmenting postoperative recovery and shortening the overall hospital stay. Preparing patients for the scheduled surgery and initiating alcohol and smoking cessation programs overhaul the patient's mental health and boost the healing process. This concept of prehabilitation a few weeks before surgery is equally beneficial compared to enhancing operative procedures and postsurgical care.
KEYWORDS
length of stay; mental health; nutrients; preoperative exercise; smoking cessation.
Topics: Humans; Preoperative Exercise; Preoperative Care; Exercise; Postoperative Care; Delivery of Health Care; Postoperative Complications
PubMed: 36705159
DOI: 10.31729/jnma.7545 -
Deutsches Arzteblatt International Jan 2015
Topics: Cardiovascular Diseases; Humans; Medical History Taking; Physical Examination; Postoperative Complications; Preoperative Care
PubMed: 25686386
DOI: 10.3238/arztebl.2015.0070a -
British Journal of Anaesthesia Jul 2000In summary, disease of the thyroid gland is common. Anaesthetists will be required to manage patients with hypothyroidism and hyperthyroidism and those requiring... (Review)
Review
In summary, disease of the thyroid gland is common. Anaesthetists will be required to manage patients with hypothyroidism and hyperthyroidism and those requiring thyroidectomy. Since anaesthesia for thyroidectomy provides many challenges of airway management, the anaesthetist should pay particular attention to preoperative assessment of the airway and should be able to deal with acute airway complications in the perioperative phase.
Topics: Anesthesia; Humans; Postoperative Complications; Preoperative Care; Thyroid Diseases; Thyroidectomy
PubMed: 10927992
DOI: 10.1093/bja/85.1.15 -
Minerva Anestesiologica Apr 2014The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification,... (Review)
Review
BACKGROUND
The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures.
METHODS
We obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations.
RESULTS
We produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests. A review of the existing literature supporting these recommendations is provided. In reaching consensus, emphasis was placed on the level of evidence, clinical relevance and the risk/benefit ratio.
CONCLUSION
Preoperative evaluation is mandatory before any diagnostic or therapeutic procedure that requires the use of anesthesia or sedation. The systematic prescription of complementary tests in children should be abandoned, and replaced by a selective and rational prescription, based on the patient history and clinical examination performed during the preoperative evaluation.
Topics: Anesthesia; Child; Child, Preschool; Critical Care; Elective Surgical Procedures; Humans; Infant; Infant, Newborn; Preoperative Care
PubMed: 24193177
DOI: No ID Found