Articles: surgery.
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Anesthesia and analgesia · Dec 2023
Observational StudyThe Perioperative Frontal Relative Ratio of the Alpha Power of Electroencephalography for Predicting Postoperative Delirium After Highly Invasive Surgery: A Prospective Observational Study.
We investigated the associations between postoperative delirium (POD) and both the relative ratio of the alpha (α)-power of electroencephalography (EEG) and inflammatory markers in a prospective, single-center observational study. ⋯ Intraoperative frontal relative ratios of the α-power of EEG were associated with POD in patients who underwent radical cancer surgery. Intraoperative EEG monitoring could be a simple and more useful tool for predicting the development of postoperative delirium than measuring perioperative acute inflammatory markers. A lower relative ratio of α-power might be an effective marker for vulnerability of brain and ultimately for the development of POD.
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Randomized Controlled Trial
Comparison of the Effects of Body Mechanics Education Methods on Pain, Disability, and Quality of Life: A Randomized Controlled Study.
Educating patients undergoing surgery for LDH is important to maintain the proper performance of body mechanics. ⋯ Preoperative education on body mechanics increases the physical functioning of patients with LDH and facilitates the integration of information into their daily activities.
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Disparity in surgical care impedes the delivery of uniformly high-quality care. Metrics that quantify disparity in care can help identify areas for needed intervention. A literature-based Disparity-Sensitive Score (DSS) system for surgical care was adapted by the Metrics for Equitable Access and Care in Surgery (MEASUR) group. The alignment between the MEASUR DSS and Delphi ratings of an expert advisory panel (EAP) regarding the disparity sensitivity of surgical quality metrics was assessed. ⋯ Applying the MEASUR DSS criteria using available literature allowed for identification of disparity-sensitive surgical metrics. The results suggest that this literature-based method of selecting quality metrics may be comparable to more complex consensus-based Delphi methods. In fields with robust literature, literature-based composite scores may be used to select quality metrics rather than assembling consensus panels.
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To characterize and quantify accumulating immunologic alterations, pre and postoperatively in patients undergoing elective surgical procedures. ⋯ The baseline immune repertoire may define an immune signature of resilience to surgical injury and help predict risk for surgical complications.
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Curr Opin Anaesthesiol · Dec 2023
Twenty-three-hour stays in the ambulatory surgical center: benefits, pathways and protocols.
To summarize recent evidence that discusses the clinical, financial, and logistical implications of a 23 h stay postsurgical stay unit in an ambulatory surgical center (ASC). ⋯ A concurrent concern with the recent increase in outpatient surgery and medical complexity of cases performed in an ambulatory surgical center (ASC) is the possibility that patients may need overnight stay. Further, whether certain patients would benefit from anticipated 23 h observation rather than same-day discharge is an emerging topic. Overnight stays in ASCs may have financial advantages and decrease the risk of unanticipated admission with proper patient selection. The use of protocols and established pathways is key to the success of this model.