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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The perioperative surgical home (PSH) has been gaining momentum, with early results linking it to lower costs, better quality, fewer emergency department (ED) visits and readmissions, and shorter stays in skilled nursing facilities or none at all. In February, the PSH Learning Collaborative, a partnership between the American Society of…

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Affordable, reliable care for adult and pediatric patients alike is the hallmark of the perioperative surgical home (PSH), as demonstrated by two organizations that are using PSH programs: a community health system and a children’s hospital. Leaders from both organizations shared their PSH journeys with OR Manager. Lower costs, shorter…

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Editor's Note The use of moderate sedation leads to better outcomes than general anesthesia for patients having transcatheter aortic valve replacement (TAVR), finds a study presented May 6 at the Society for Cardiovascular Angiography and Interventions annual meeting in Orlando, Florida. Of 10,997 patients included in the study, 1,737 received…

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Editor's Note The overall risk of complications after colonoscopy increases when patients receive anesthesia, this study finds. The use of anesthesia was associated with a 13% increase in complications within 30 days, including a higher risk of perforation, hemorrhage, and abdominal pain. The risk of perforation was 26% higher in…

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Editor's Note After six consecutive night shifts, anesthesia residents experienced significantly impaired control of all driving variables including speed, lane position, throttle, and steering in a driving simulator. They also were more likely to be involved in collisions. In addition, reaction times increased with a significant increase in the number of minor…

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Editor's Note Peripheral nerve blocks were associated with fewer complications and lower costs in total hip and knee patients in this study, which was presented March 23 at the annual meeting of the American Society of Regional Anesthesia and Pain Medicine. In this analysis of more than 1 million patients…

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Editor's Note In this work system analysis, the inclusion of prefilled syringes into medication delivery by anesthesia providers simplified work processes and reduced the number and associated risks of system vulnerabilities. Eight system vulnerabilities were found in the prefilled syringe system versus 21 in the self-filled syringe system. An example…

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Enhanced recovery after surgery (ERAS) programs are gaining ground with recent data showing that they improve outcomes. The programs consist of multidisciplinary, evidence-based protocols implemented in the perioperative period to provide standardized patient care. Like other changes in healthcare delivery, adopting ERAS programs takes time and effort. Despite positive results…

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Editor's Note This study of 8,503 middle-aged and elderly twins in the Netherlands found no clinically significant association of major surgery and anesthesia with long-term cognitive dysfunction. The findings suggest that preoperative cognitive functioning and underlying diseases have stronger influence on postoperative cognitive abilities. The study provided a powerful approach…

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