Articles: operative.
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Anesthesia and analgesia · Mar 2022
ReviewThe Triple Bottom Line and Stabilization Wedges: A Framework for Perioperative Sustainability.
We present a narrative review of environmental sustainability aimed at perioperative clinicians. The review will familiarize readers with the triple bottom line framework, which aims to align the goals of delivering high-quality patient care, promoting environmental sustainability, and improving the financial position of health care organizations. We introduce the stabilization wedges model for climate change action adopted for the perioperative setting and discuss areas in which perioperative leaders can make sustainable choices. The goal of this review is to increase awareness among perioperative physicians of the environmental impacts of surgical and anesthetic care, promote engagement with sustainability efforts as a topic of professional concern for our specialty, and inspire new research in perioperative environmental sustainability.
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Minerva anestesiologica · Mar 2022
Randomized Controlled TrialShort-term perioperative cognitive therapy combined with rehabilitation exercise reduces the incidence of neurocognitive disorder in elderly patients: a randomized controlled trial.
To investigate whether short-term perioperative cognitive therapy combined with rehabilitation exercise decreases the incidence of neurocognitive disorder (NCD) in elderly patients who have undergone hip joint replacement surgery. This was a randomized, parallel controlled trial on elderly patients who underwent unilateral total hip joint replacement surgery at the Third Xiangya Hospital of Central South University. ⋯ Our study indicates that perioperative cognitive therapy combined with rehabilitation exercise can effectively reduce the incidence of NCD in elderly patients after total hip joint replacement surgery.
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Anesthesia and analgesia · Mar 2022
The Perioperative Use of Benzodiazepines for Major Orthopedic Surgery in the United States.
Despite numerous indications for perioperative benzodiazepine use, associated risks may be exacerbated in elderly and comorbid patients. In the absence of national utilization data, we aimed to describe utilization patterns using national claims data from total hip/knee arthroplasty patients (THA/TKA), an increasingly older and vulnerable surgical population. ⋯ Based on a representative sample, 4 of 5 patients undergoing major orthopedic surgery in the United States receive benzodiazepines perioperatively, despite concerns for delirium and delayed postoperative neurocognitive recovery. Notably, benzodiazepine utilization was coupled with substantially increased opioid use, which may project implications for perioperative pain management.