Articles: postoperative.
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The authors evaluated the effect of preoperative β-blocker use on early outcomes in patients undergoing coronary artery bypass grafting (CABG) in Japan. ⋯ In this nationwide registry, the use of preoperative β-blockers did not affect short-term mortality or morbidity in patients undergoing CABG.
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Obstructive sleep apnea (OSA) may increase the incidence of postoperative complications when undiagnosed. The purpose of this study was to evaluate the perspectives of Canadian anesthesiologists regarding the perioperative management of patients with diagnosed or suspected OSA. ⋯ The majority of anesthesiologists continue to rely on clinical suspicion alone to identify OSA. Moreover, the lack of institutional policy is concerning. A concerted effort to develop an evidence-based guideline may be the next step to assist institutions.
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Comparative Study
Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study.
Half of postoperative patients are prescribed an opioid, but a majority do not store or dispose of them properly thus risking diversion. We examined the efficacy of an opioid educational pamphlet addressing opioid weaning, storage, and disposal. We hypothesized that the pamphlet would increase the rate of proper opioid disposal, storage, and weaning. ⋯ The introduction of an education pamphlet significantly improved self-reported proper opioid disposal rates in postoperative patients.
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Minerva anestesiologica · Jan 2016
Observational StudyFeasibility and results of a fast-track protocol in thoracic surgery.
A rehabilitation program, a multimodal strategy favoring rapid postoperative return to autonomy, has rarely been undertaken after thoracic surgery compared to colectomy. The primary outcome of this fast-track program was the length of postoperative stay. Secondary outcomes concerned the feasibility of this strategy, the incidence of postoperative complications and 3-month postoperative mortality. ⋯ A program for early rehabilitation is feasible after thoracotomy. Chest drainage and organization to optimize the length of stay are crucial points.
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Among patients with OSA, a higher number of medical morbidities are known to be associated with those who have obesity hypoventilation syndrome (OHS) compared with OSA alone. OHS can pose a higher risk of postoperative complications after elective noncardiac surgery (NCS) and often is unrecognized at the time of surgery. The objective of this study was to retrospectively identify patients with OHS and compare their postoperative outcomes with those of patients with OSA alone. ⋯ Better emphasis is needed on preoperative recognition of hypercapnia among patients with OSA or overlap syndrome undergoing elective NCS.