Editor's Note Administering acetaminophen (Tylenol) during surgery may help reduce the incidence of postoperative shivering, finds a study presented October 21 at the Anesthesiology 2017 annual meeting in Boston. A total of 37 patients scheduled for gynecologic surgery were randomly assigned to receive IV acetaminophen or a placebo after general…

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Editor's Note Most elderly hip fractures occur during warm months, and a greater number happen indoors rather than out, finds this study presented October 23 at the Anesthesiology 2017 annual meeting in Boston. In this analysis of 544 hip fracture patients treated at The Hospital of Central Connecticut from 2013…

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Editor's Note Eliminating opioids from general anesthesia is safe and effective and significantly decreases postoperative nausea, finds this study presented October 23 at the Anesthesiology 2017 annual meeting in Boston. Of 1,009 patients who received general anesthesia without opioids, only 11% experienced postoperative nausea--typically 50% to 80% of patients have…

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Editor's Note In patients 85 years of age and older, surgical complexity and certain geriatric variables (malnutrition, frailty), which are overlooked in American Society of Anesthesiologists and most other scores, were relevant in predicting postoperative outcomes and mortality, finds this study. Of 127 patients who completed follow-up, 30-day mortality was…

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Editor's Note This meta-analysis found that patients at higher risk for obstructive sleep apnea (OSA), as determined by preoperative STOP-Bang screening, had a higher risk of postoperative adverse events and longer length of hospital stay, compared with lower risk-OSA patients. The analysis included 10 studies with 23,609 patients (7,877 high-risk…

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Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…

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Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…

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Editor's Note Using patient-specific preoperative variables, a validated logistic regression model predicted transfusions in total hip and knee patients in this study. The model identified preoperative hemoglobin, total hip arthroplasty, and females 65 years of age and older as predictors of perioperative transfusions. The model also may help identify those…

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Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…

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Editor's Note In this study, the use of preoperative and postoperative elements of a Perioperative Surgical Home model in total knee and hip patients was associated with improvements in operational outcomes. The study included 1,225 patients in a preintervention PSH group and 1,363 in a postintervention PSH group. Compared with…

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