Anesthesia Editor's Note Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds. Of 211 patients 65 years of age…
Editor's Note Opioid use in total hip and knee patients decreased by one-third between 2006 and 2014, which reflects success in the use of a multimodal approach (ie, opioids plus additional pain management methods, such as peripheral nerve blocks and acetaminophen) to pain management, finds this study presented October 21…
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…
Editor's Note Standardizing clinical processes for outpatient hernia repairs reduced postoperative pain and unplanned returns to the emergency department (ED), finds this study presented October 23 at the American College of Surgeons 2017 Clinical Congress in San Diego. Researchers developed a standardized eight-step protocol that incorporated best practices and enhanced…
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…
Editor's Note Patients significantly overestimate the amount of pain they will experience after surgery, which can cause unnecessary anxiety, finds a study presented October 21 at the Anesthesiology 2017 annual meeting in Boston. A total of 223 patients completed a questionnaire before and after surgery to evaluate the level of…
Throughput inefficiencies are a growing problem in surgical services departments. Patients are held in the OR because there is no room in the postanesthesia care unit (PACU), and patients are held in the PACU because there are no beds available in the patient care unit or because outpatients having major…
Editor's Note After implementation of an anesthesia information management system (AIMS)-based mandatory quality assurance process for reporting of intraoperative adverse events at two academic medical centers, documented adverse events decreased significantly, this study finds. Over a 2-year period after implementation of mandatory reporting, the adverse event rate at Thomas Jefferson…
Editor's Note In this analysis of patient falls from OR and procedure tables during anesthesia care, researchers queried two independent closed claims databases. They identified 21 claims (1.2% of cases) in the American Society of Anesthesiologists (ASA) Closed Claims Project and 0.07% of cases in the secure records of a…
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…
