Articles

Can routine perioperative haemodynamic parameters predict postoperative morbidity after major surgery?

Postoperative morbidity occurs in 10–15% of patients undergoing major noncardiac surgery. Predicting patients at higher risk of morbidity may help to optimize perioperative prevention. Preoperative haemodynami...

Authors: Jean-Francois Bonnet, Eleanor Buggy, Barbara Cusack, Aislinn Sherwin, Tom Wall, Maria Fitzgibbon and Donal J. Buggy

Prioritisation of quality indicators for elective perioperative care: a Delphi consensus

A systematic review of the peer-reviewed and grey literature previously identified over 1200 perioperative structure and process quality indicators. We undertook a Delphi consensus process with the aim of crea...

Authors: D. Gilhooly, M. Chazapis and S. R. Moonesinghe

Extended versus inpatient thromboprophylaxis with heparins following major open abdominopelvic surgery for malignancy: a systematic review of efficacy and safety

Patients undergoing open abdominopelvic procedures for malignancy are at high risk of postoperative venous thromboembolism (VTE). This risk can be mitigated with prophylaxis; however, optimum duration in this ...

Authors: B. Heijkoop, S. Nadi, D. Spernat and G. Kiroff

Adherence to recommended practices for perioperative anesthesia care for older adults among US anesthesiologists: results from the ASA Committee on Geriatric Anesthesia-Perioperative Brain Health Initiative ASA member survey

While specific practices for perioperative care of older adults have been recommended, little is known regarding adherence by US physician anesthesiologists to such practices. To address this gap in knowledge,...

Authors: Stacie Deiner, Lee A. Fleisher, Jacqueline M. Leung, Carol Peden, Thomas Miller and Mark D. Neuman

Natriuretic peptide-directed medical therapy: a systematic review

Natriuretic peptides (NP) are strongly associated with perioperative cardiovascular events. However, in patients with raised NP, it remains unknown whether treatment to reduce NP levels prior to surgery result...

Authors: Christella S. Alphonsus, Pooveshnie Govender, Reitze N. Rodseth and Bruce M. Biccard

The value of teachable moments in surgical patient care and the supportive role of digital technologies

Evidence strongly supports improved outcomes following surgery when patients are more physically active, have better dietary intake, or are generally fitter prior to surgery. Having an operation is a major lif...

Authors: Anna Robinson, Robert Slight, Andrew Husband and Sarah Slight

Waardenburg-Shah syndrome (WS type IV): a rare case from Pakistan

Waardenburg-Shah syndrome is a rare autosomal recessive [AR] inherited disorder characterized by the presence of Hirschsprung’s disease with a high likelihood of aganglionic megacolon, due to which the mortali...

Authors: Taimoor Ashraf Khan, C. Aqeel Safdar, Shehryar Zameer and Arshad Khushdil

The emerging specialty of perioperative medicine: a UK survey of the attitudes and behaviours of anaesthetists

In 2014, the Royal College of Anaesthetists (RCoA) launched the Perioperative Medicine Programme to facilitate the delivery of best preoperative, intraoperative and postoperative care through implementation of...

Authors: J. S. L. Partridge, A. Rogerson, A. L. Joughin, D. Walker, J. Simon, M. Swart and J. K. Dhesi

Technical and clinical evaluation of a closed loop TIVA system with SEDLine^TM spectral density monitoring: Multicentric prospective cohort study

Closed loop total intravenous anesthesia is a technique in which the patient’s hemodynamic and anesthetic depth variables are monitored, and based on this information, a computer controls the infusion rate of ...

Authors: Claudia Castellanos Peñaranda, Fabián D. Casas Arroyave, Francisco J. Gómez, Paola A. Pinzón Corredor, Juan M. Fernández, Marcela Velez Botero, Juan D. Bohórquez Bedoya and Carlos Marulanda Toro

A significant proportion of venous thromboembolism events in general surgical patients occurs after discharge: analysis of the ACS-NSQIP Essentials database

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in general surgical patients.

Authors: Abdelghaffar K. Salous, Ashraf Reyad, Karen Sweeney and Arun Mavanur

Cannabis-based medicines and the perioperative physician

The increasing availability of cannabis for both recreational and medicinal purposes means that anaesthetists will encounter an increasing number of patients taking cannabis-based medications. The existing evi...

Authors: Patrick Tapley and Suzanne Kellett

Compliance, adherence and effectiveness of a community-based pre-operative exercise programme: a pilot study

Pre-operative exercise training improves HR components of fitness and HRQoL following hospital-based programmes.

Authors: Lisa Loughney, Ronan Cahill, Kiaran O’Malley, Noel McCaffrey and Brona Furlong

Focused cardiac ultrasound in preoperative assessment: the perioperative provider’s new stethoscope?

Focused cardiac ultrasound (FoCUS)—a simplified, qualitative version of echocardiography—is a well-established tool in the armamentarium of critical care and emergency medicine. This review explores the extent...

Authors: Tara Lenk, John Whittle, Timothy E. Miller, David G. A. Williams and Yuriy S. Bronshteyn

Standard coagulation assays alone are not sufficient to exclude surgically relevant rivaroxaban plasma concentrations

While mainly larger hospitals have introduced routine anti-Xa assays for rivaroxaban (RXA), these are not readily available to smaller hospitals often relying on routine coagulation tests such as prothrombin t...

Authors: Alexander Kaserer, Andreas Schedler, Burkhardt Seifert, Donat R. Spahn, Jan-Dirk Studt and Philipp Stein

The role of cardiac rehabilitation using exercise to decrease natriuretic peptide levels in non-surgical patients: a systematic review

Exercise is recommended in patients with cardiac failure. In the perioperative patient, exercise is also gaining popularity as a form of prehabilitation. In this meta-analysis, we examine if exercise is able t...

Authors: Christella S. Alphonsus, Pooveshni Govender, Reitze N. Rodseth and Bruce M. Biccard

Large volume infusions of hydroxyethyl starch during cardiothoracic surgery may be associated with postoperative kidney injury: propensity-matched analysis

The safety of intraoperative administration of hydroxyethyl starch (HES) has been debated. We hypothesized that intraoperative use of HES is associated with postoperative acute kidney injury (AKI) following ca...

Authors: Wataru Matsunaga, Masamitsu Sanui, Yusuke Sasabuchi, Yasuma Kobayashi, Asuka Kitajima, Fumitaka Yanase, Yutaka Takisawa and Alan Kawarai Lefor

Correction to: Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India

Following publication of the original article (Machowska et al. 2019), the authors provided new footnotes for Table 1 and Table 2. The complete tables and updated footnotes are supplied below.

Authors: Anna Machowska, Jonatan Sparrentoft, Shyam Kumar Dhakaita, Cecilia StålsbyLundborg and Megha Sharma

Primer on adult patient satisfaction in perioperative settings

The topic of patient satisfaction has gained increasing importance over the past decade. Due to the impact of patient satisfaction on health care quality, understanding factors that predict satisfaction is vit...

Authors: Lily N. Trinh, Michelle A. Fortier and Zeev N. Kain

Perioperative antibiotic prescribing in surgery departments of two private sector hospitals in Madhya Pradesh, India

Single-dose perioperative antibiotic prophylaxis (PAP) is recommended for clean, non-infectious surgeries to prevent surgical site infections. However, the common practice of unindicated use and prolonged use ...

Authors: Anna Machowska, Jonatan Sparrentoft, Shyam Kumar Dhakaita, Cecilia StålsbyLundborg and Megha Sharma

Impact of an enhanced recovery pathway on length of stay and complications in elective radical cystectomy: a before and after cohort study

Enhanced recovery after surgery (ERAS) pathways aim to standardize and integrate perioperative care, incorporating the best available evidence-based practice throughout the perioperative period targeted at att...

Authors: W. Jonathan Dunkman, Michael W. Manning, John Whittle, John Hunting, Edward N. Rampersaud, Brant A. Inman, Julie K. Thacker and Timothy E. Miller

A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)

Hip fracture is a procedure with high mortality and complication rates, and there exists a group especially at risk of these outcomes identified by their Nottingham Hip Fracture Score (NHFS). Meta-analysis sug...

Authors: S. J. Davies, D. R. Yates, R. J. T. Wilson, Z. Murphy, A. Gibson, V. Allgar and T. Collyer

Perioperative fluid management: moving toward more answers than questions—a commentary on the RELIEF study

Perioperative fluid and hemodynamic management have been much-debated topics over the last few years. Recently, a number of large trials have been published to help inform this debate. The Restrictive versus L...

Authors: Timothy E. Miller and Rupert M. Pearse

Data integrity issues: catalyst for a more robust approach to research on perioperative oxygen therapy?

Authors: Alex H. Oldman, Andrew F. Cumpstey, Daniel S. Martin and Michael P. W. Grocott

A retrospective evaluation of the impact of patient ethnicity on the use of epidural analgesia or blood transfusions in children undergoing major oncologic surgery

The impact of patient ethnicity on healthcare delivery is well documented. In this study of children who had undergone open abdominal or pelvic surgery for tumor resection, we sought to compare the use of epid...

Authors: Pascal Owusu-Agyemang, Juan P. Cata, Ravish Kapoor, Antoinette Van Meter, Acsa M. Zavala, Uduak U. Williams, January Y. Tsai, Lei Feng and Andrea Hayes-Jordan

The effect of virtual reality technology on preoperative anxiety in children: a Solomon four-group randomized clinical trial

Preoperative anxiety correlates positively with the amount of postoperative pain, analgesic use, and length of hospital stay. The purpose of this study was to investigate the effect of virtual reality technolo...

Authors: Fateme Dehghan, Rostam Jalali and Hasan Bashiri

Enhanced recovery after surgery (ERAS) program for lumbar spine fusion

There is a paucity of literature regarding the implementation of enhanced recovery after surgery (ERAS) protocols for open lumbar spine fusions. We implemented an ERAS program for 1–2-level lumbar spine fusion...

Authors: Justin Smith, Stephen Probst, Colleen Calandra, Raphael Davis, Kentaro Sugimoto, Lizhou Nie, Tong J. Gan and Elliott Bennett-Guerrero

Factors influencing day surgery patients’ quality of postoperative recovery and satisfaction with recovery: a narrative review

The aim of healthcare services is to provide a high quality of care. One way to ensure that this aim has been fulfilled is to assess patients’ satisfaction with their care. Although satisfaction is a complex c...

Authors: Maria Jaensson, Karuna Dahlberg and Ulrica Nilsson

Intravenous lidocaine infusion as a component of multimodal analgesia for colorectal surgery—measurement of plasma levels

Growing evidence suggests that intravenous lidocaine as a component of multimodal analgesia improves recovery after major colorectal surgery. There is little published data regarding ideal dosing and target pl...

Authors: E. Greenwood, S. Nimmo, H. Paterson, N. Homer and I. Foo

Anesthetic consideration for airway management of patients undergoing endoscopic fibrin glue treatment of tracheobronchial rupture: a case series of three patients

Tracheobronchial ruptures are very severe and life-threatening injuries. The origin of such airway damage is trauma or an iatrogenic event. Last year, we operated on three different cases of tracheal ruptures ...

Authors: Vincenzo Pota, Pasquale Sansone, Alfonso Fiorelli, Maria Beatrice Passavanti, Mauro D’Amora, Paola Vosa, Elena Bignami, Maria Caterina Pace and Caterina Aurilio

Acute kidney injury in postoperative shock: is hyperoncotic albumin administration an unrecognized resuscitation risk factor?

The use of hyperoncotic albumin (HA) for shock resuscitation is controversial given concerns about its cost, effectiveness, and potential for nephrotoxicity. We evaluated the association between early exposure...

Authors: Chiedozie I. Udeh, Jing You, Matthew R. Wanek, Jarrod Dalton, Belinda L. Udeh, Sevag Demirjian, Nadeem Rahman and J. Steven Hata

Perioperative administration of buffered versus non-buffered crystalloid intravenous fluid to improve outcomes following adult surgical procedures: a Cochrane systematic review

Buffered intravenous fluid preparations contain substrates to maintain acid-base status. The objective of this systematic review was to compare the effects of buffered and non-buffered fluids administered duri...

Authors: Peter M. Odor, Sohail Bampoe, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J. Gan, Michael P. W. Grocott, Michael F. M. James, Michael G. Mythen, Catherine M. N. O’Malley, Anthony M. Roche, Kathy Rowan and Edward Burdett

What is the effect of perioperative intravenous iron therapy in patients undergoing non-elective surgery? A systematic review with meta-analysis and trial sequential analysis

Guidelines to treat anaemia with intravenous (IV) iron have focused on elective surgical patients with little attention paid to those undergoing non-elective/emergency surgery. Whilst these patients may experi...

Authors: Akshay Shah, Antony J. R. Palmer, Sheila A. Fisher, Shah M. Rahman, Susan Brunskill, Carolyn Doree, Jack Reid, Anita Sugavanam and Simon J. Stanworth

Characterizing post-extubation negative pressure pulmonary edema in the operating room—a retrospective matched case-control study

Post-extubation negative pressure pulmonary edema (NPPE) is an uncommon but important anesthesia-related emergency presenting with acute respiratory distress and hypoxemia after removal of airway devices. This...

Authors: Pei-Hsin Tsai, Jen-Hung Wang, Shian-Che Huang, Yen-Kuang Lin and Chen-Fuh Lam

Predictors of chronic prescription opioid use after orthopedic surgery: derivation of a clinical prediction rule.

Prescription opioid use at high doses or over extended periods of time is associated with adverse outcomes, including dependency and abuse. The aim of this study was to identify mediating variables that predic...

Authors: Daniel I Rhon, Suzanne J Snodgrass, Joshua A Cleland, Charles D Sissel and Chad E Cook

A prospective case series evaluating use of an in-line air detection and purging system to reduce air burden during major surgery

Intravascular air embolism (AE) is a preventable but potentially catastrophic complication caused by intravenous tubing, trauma, and diagnostic and surgical procedures. The potentially fatal risks of arterial ...

Authors: Yussr M. Ibrahim, Nicole R. Marques, Carlos R. Garcia, Michael Salter, Christopher McQuitty, Michael Kinsky, Mindy Juan and Achiau Ludomirsky

Pulmonary artery catheter use in adult patients undergoing cardiac surgery: a retrospective, cohort study

The utility of pulmonary artery catheters (PACs) and their measurements depend on a variety of factors including data interpretation and personnel training. This US multi-center, retrospective electronic healt...

Authors: Andrew D. Shaw, Michael G. Mythen, Douglas Shook, David K. Hayashida, Xuan Zhang, Jeffrey R. Skaar, Sloka S. Iyengar and Sibyl H. Munson

Correction to: Intraoperative oxygenation in adult patients undergoing surgery (iOPS): a retrospective observational study across 29 UK hospitals

Following publication of the original article (Morkane et al., 2018), it was noticed that the second collaborating group ‘South Coast Perioperative Audit and Research Collaboration (SPARC)’ was not displayed o...

Authors: Clare M. Morkane, Helen McKenna, Andrew F. Cumpstey, Alex H. Oldman, Michael P. W. Grocott and Daniel S. Martin

Clinical and economic impact of goal-directed fluid therapy during elective gastrointestinal surgery

Several randomized controlled trials suggest that goal-directed fluid therapy (GDFT) may result in improved postoperative outcomes. The aim of this study was to assess the clinical and financial impact of the ...

Authors: Juying Jin, Su Min, Dan Liu, Ling Liu and Bixiao Lv

Relationship between endotoxin core, staphylococcal and varicella antibody levels and outcome following aortic valve replacement surgery: a prospective observational study

Morbidity and mortality following cardiac valve surgery is high. Immunity is an important contributor to outcome. This study examines the relationship of staphylococcal and endotoxin antibody levels to outcome...

Authors: Andrew Smith, Sarka Moravcova, Thomas A. Treibel, Patricia Colque-Navarro, Roland Mollby, James C. Moon and Colin Hamilton-Davies

Comparison of dextran and albumin on blood coagulation in patients undergoing major gynaecological surgery

Hydroxyethyl starches have been withdrawn from the European market. In Sweden, dextran was the main colloid until 2000, when starches overtook the market. After the recent 6S-trial, it was suggested that dextr...

Authors: Johann Sigurjonsson, David Hedman, Peter Bansch and Ulf Schött

Patient-reported outcomes 6 months after enhanced recovery after colorectal surgery

Enhanced recovery after surgery (ERAS) programs have been established as perioperative strategies associated with improved outcomes. However, intermediate and long-term patient-reported outcome data for patien...

Authors: Thomas Deiss, Lee-lynn Chen, Ankit Sarin and Ramana K. Naidu

Recruitment of sublingual microcirculation using handheld incident dark field imaging as a routine measurement tool during the postoperative de-escalation phase—a pilot study in post ICU cardiac surgery patients

Management of tissue perfusion following cardiac surgery is a challenging task where common clinical parameters do not reflect microcirculatory dysfunction. Heterogeneity in blood flow perfusion and abnormalit...

Authors: Zühre Uz, Can Ince, Philippe Guerci, Yasin Ince, Renata P. Araujo, Bulent Ergin, Matthias P. Hilty, Thomas M. van Gulik and Bas A. de Mol

Intraoperative oxygenation in adult patients undergoing surgery (iOPS): a retrospective observational study across 29 UK hospitals

Considerable controversy remains about how much oxygen patients should receive during surgery. The 2016 World Health Organization (WHO) guidelines recommend that intubated patients receive a fractional inspire...

Authors: Clare M. Morkane, Helen McKenna, Andrew F. Cumpstey, Alex H. Oldman, Michael P. W. Grocott and Daniel S. Martin

The rising tide of opioid use and abuse: the role of the anesthesiologist

Opioid use has risen dramatically in the past three decades. In the USA, opioid overdose has become a leading cause of unintentional death, surpassing motor vehicle accidents. A patient’s first exposure to opi...

Authors: Elena J. Koepke, Erin L. Manning, Timothy E. Miller, Arun Ganesh, David G. A. Williams and Michael W. Manning

Comparing the experience of enhanced recovery programme for gynaecological patients undergoing laparoscopic versus open gynaecological surgery: a prospective study

Enhanced recovery has been shown to improve patients’ experience after surgery. There are no previous studies comparing patients’ experience between those undergoing laparoscopic and open gynaecological surger...

Authors: Joanne Lee, Viren Asher, Arun Nair, Victoria White, Catherine Brocklehurst, Martyn Traves and Anish Bali

Clinical agreement in the American Society of Anesthesiologists physical status classification

The American Society of Anesthesiologists physical status (ASA-PS) classification is not intended to predict risk, but increasing ASA-PS class has been associated with increased perioperative mortality. The AS...

Authors: Kayla M. Knuf, Christopher V. Maani and Adrienne K. Cummings

Anesthesiologists as perioperative hospitalists and outcomes in patients undergoing major urologic surgery: a historical prospective, comparative effectiveness study

Perioperative care has been identified as an area of wide variability in quality, with conflicting models, and involving multiple specialties. In 2014, the Loma Linda University Departments of Anesthesiology a...

Authors: Gary Stier, Davinder Ramsingh, Ronak Raval, Gary Shih, Bryan Halverson, Briahnna Austin, Joseph Soo, Herbert Ruckle and Robert Martin

Self-reported mobility as a preoperative risk assessment tool in older surgical patients compared to the American College of Surgeons National Surgical Quality Improvement Program

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP®) developed a surgical risk calculator using data from 1.4 million patients and including 1557 unique Current Procedural Te...

Authors: Sunghye Kim, Rebecca Neiberg, W. Jack Rejeski, Anthony P. Marsh, Stephen B. Kritchevsky, Xiaoyan I. Leng and Leanne Groban

The relationship between cardiopulmonary exercise test variables, the systemic inflammatory response, and complications following surgery for colorectal cancer

Both preoperative cardiopulmonary exercise test (CPET)-derived measures of fitness and postoperative C-reactive protein (CRP) concentrations are associated with complications following surgery for colorectal c...

Authors: Stephen T. McSorley, Campbell S. D. Roxburgh, Paul G. Horgan and Donald C. McMillan

Perioperative corticosteroid administration: a systematic review and descriptive analysis

Perioperative administration of corticosteroid is common and variable. Guidelines for perioperative corticosteroid administration before non-cardiac non-transplant surgery in patients with current or previous ...

Authors: C. Groleau, S. N. Morin, L. Vautour, A. Amar-Zifkin and A. Bessissow