Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Pragmatic Clinical Trial
Starting a surgical prehabilitation program: results from a pragmatic nonrandomized feasibility study.
We sought to assess the feasibility and estimate the effects on outcomes of a multimodal prehabilitation service implemented as an ancillary surgical service. ⋯ Multimodal surgical prehabilitation is feasible as an integrated clinical service and may be effective for improving physical and psychological outcomes. Further evaluations of clinically integrated prehabilitation programs in Canada are needed to confirm these findings.
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Meta Analysis
Effects of dexamethasone on opioid consumption in pediatric tonsillectomy: a systematic review with meta-analysis.
Tonsillectomy is one of the most common ambulatory procedures performed in children worldwide, with around 40,000 procedures performed in Canada every year. Although a prior systematic review indicated a clear role for dexamethasone as an analgesic adjunct, the quantity effect on opioid consumption is unknown. In the current systematic review with meta-analysis, we hypothesized that the use of dexamethasone reduces perioperative opioid consumption in pediatric tonsillectomy but does not increase rates of postoperative hemorrhage. ⋯ PROSPERO ( CRD42023440949 ); first submitted 4 September 2023.
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The management of pain following cancer-related surgeries involves the use of opioid analgesics. Nevertheless, there is little evidence characterizing the utility and prescription patterns of opioids after these procedures. Our primary aim was to identify patients from three types of cancer surgery who were overprescribed with opioids. The secondary aim was to determine the potential predictors of overprescribing in the same period. ⋯ Our study shows that the majority of recruited patients undergoing breast, gynecologic, or head and neck cancer surgery were overprescribed opioids. Individualized assessments on patients' 24-hr opioid requirements before discharge and supplying for less than five days are important considerations to reduce overprescribing in opioid-naïve patients after cancer surgery.
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Subcutaneous emphysema is a common complication of laparoscopic surgery. We aimed to determine the incidence, outcomes, and risk factors of postlaparoscopic subcutaneous emphysema. ⋯ This historical cohort study showed a relatively high incidence of postlaparoscopic subcutaneous emphysema. In addition to previously reported risk factors, female sex and use of the AirSeal Intelligent Flow System were found to be associated with postlaparoscopic subcutaneous emphysema.