Health literacy and anesthesia: patients' knowledge of anesthesiologist roles and information desired in the preoperative visit.

Study Objective: To assess patients' knowledge of the role of the anesthesiologist and to identify information patients desire during the preoperative visit.

Design: Self-administered structured survey evaluation.

Setting: Preoperative Evaluation Clinic at Mayo Clinic, Rochester, Minnesota.

Randomised trial of intranasal nicotine and postoperative pain, nausea and vomiting in non-smoking women.

Background: The primary aim of this study is to test the hypothesis that intranasal nicotine reduces postoperative opioid use among non-smoking women. The second aim is to determine the effects of intranasal nicotine on the incidence of postoperative nausea and vomiting (PONV).

Methods: In this double-blind, randomised placebo-controlled trial, non-smoking women undergoing gynaecological procedures received either 3 mg intranasal nicotine (N=90) or placebo spray (N=89) at the conclusion of surgery.

Clinician-delivered intervention to facilitate tobacco quitline use by surgical patients.

Background: Telephone quitlines that provide counseling support are efficacious in helping cigarette smokers quit and have been widely disseminated; currently, they are underused. Surgery represents a teachable moment for smoking cessation, which can benefit surgical outcomes; however, few surgical patients receive smoking cessation interventions. This study developed and tested a clinician-delivered intervention to facilitate quitline use by adult patients scheduled for elective surgery.

Drug-eluting stents: patient understanding of the risks of premature cessation of antiplatelet drugs.

Objective: Drug-eluting coronary stent use is common. Antiplatelet drug use after stent placement is necessary to prevent stent thrombosis. It has been recommended that at the time of stent placement, patients be given instructions regarding stopping antiplatelet drugs before elective surgery.

Preoperative evaluation of patients with history of allergy to penicillin: comparison of 2 models of practice.

Objective: To study whether allergy consultation and penicillin allergy skin testing affects the selection of antibacterial prophylaxis perioperatively in surgical patients with history of allergy to penicillin (HOAP).

Patients And Methods: From January 1 through June 30, 2004, we compared 2 different models of practice at our institution. At the Preoperative Evaluation Clinic (POEC), all patients with HOAP are evaluated by an allergist and undergo skin testing for allergy to penicillin.

Angiotensin system inhibitors in a general surgical population.

We studied the relationship between the timing of discontinuing chronic angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor subtype 1 antagonists (ARA) and hypotension after the induction of general anesthesia in a general surgical population. We retrospectively studied 267 hypertensive patients receiving chronic ACEI/ARA therapy undergoing elective noncardiac surgery under general anesthesia. During preoperative visits, patients were asked to either take their last ACEI/ARA therapy on the morning of surgery or withhold it up to 24 h before surgery.