Editor's Note These guidelines were developed to provide a more efficient and cost-effective preoperative workup of patients with diagnosed or suspected obstructive sleep apnea (OSA). They examine the existing evidence-base for preoperative screening and preparation of patients with OSA, as well as the perioperative use of CPAP in patients with…

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Editor's Note Children who have surgery before primary school age are at increased risk of early developmental vulnerability, but the difference between exposed and unexposed children is small, finds this study. The analysis included 28,366 children (age 5-6 years) who had surgery and 55,910 children who did not have surgery…

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Editor's Note Postoperative ischemic optic neuropathy (ION) in spinal fusion patients significantly decreased from 1998 to 2012 by almost 3-fold, this study finds. Age over 50, male gender, blood transfusion during procedure, and obesity significantly increased the risk of ION. The authors attribute the decline in risk to the increasing…

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Editor's Note The American Society of Anesthesiologists announced June 22 that the American Academy of Orthopaedic Surgeons (AAOS) is participating in the development of the Perioperative Surgical Home (PSH) model of care. The expected benefits include enhanced clinical quality, better patient experience, lower complication rates and readmissions, reduce length of…

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Editor's Note In this study, researchers from the University of California, Irvine, report on data for the second year of implementation of the total joint replacement Perioperative Surgical Home program. During the 2-year period there were 328 primary joint arthroplasty patients. Length of stay was significantly shorter in the second…

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Editor's Note Compared with type of procedure, differences between surgeons account for a small part of OR time variability, and the effect of differences between anesthesiologists is negligible, this study finds. Differences between surgeons accounted for 2.9% of variability in OR time, and differences between anesthesiologists accounted for 0.1%.  …

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Editor's Note Children who received a single general anesthesia under age 3 had similar IQ, behavior, language, and mental functions, including attention, learning, memory, and thinking speed, between ages 8 and 15, compared with siblings who didn’t receive general anesthesia, this study finds. This multi-center study led by researchers at…

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Editor's Note Scope of practice restrictions and physician supervision requirements for nurse anesthetists have no impact on anesthesia patient safety, this study finds. Examining 5.7 million anesthesia cases, researchers found that anesthesia complications differed significantly with: patient characteristics patient comorbidities the procedures being administered. Complication odds did not differ by…

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Editor's Note As part of the drive to reduce opioid use, rotator-cuff repairs are becoming a testing ground for alternative approaches to pain management, the May 23 Wall Street Journal reports. Because rotator-cuff surgery is one of the most painful procedures to recover from, physicians hope that if alternative painkilling…

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Editor's Note A new measure for assessing the body’s response to painful stimuli during surgery may allow for better anesthesia management, less pain when regaining consciousness, and better postoperative outcomes, this study finds. The measure, called the nociception (pain) level index, uses an algorithm to process multiple hormonal and neurological…

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