Journal of anesthesia
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Journal of anesthesia · Dec 2024
Current practice and awareness of perioperative do-not-attempt-resuscitation orders: a single-center retrospective survey and complete questionnaire survey.
We investigated whether patients who have been issued a do-not-attempt-resuscitation order (DNAR) preoperatively (hereafter, DNAR patients) are informed of the DNAR code change when they undergo anesthesia. We also conducted a survey of the awareness of medical staff regarding perioperative DNARs, and investigated the current situation at a single-center in Japan. ⋯ In clinical practice, 27% of DNAR patients were informed of DNARs code change before surgery. Perioperative advance care planning should be further promoted in clinical practice by creating guidelines and training programs regarding perioperative DNARs.
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Journal of anesthesia · Dec 2024
Day surgery in children: 15-year analysis of unplanned admissions at a Japanese tertiary children's hospital.
Unplanned hospital admission following pediatric day surgery is a crucial quality indicator. This study examined the incidence, related risks, interventions, and outcomes of unplanned hospital admission following pediatric day surgery among children in Japan. ⋯ Unplanned hospital admission was most commonly anesthetic-related and was managed with intravenous fluids and antiemetic medications. Longer operation time and later exit from the operating room were significant risk factors. These findings can guide targeted strategies to further reduce unplanned hospital admission and improve pediatric day surgery quality.