: Peri-operative Medicine is the patient-centred and value-based multidisciplinary peri-operative care of surgical patients. Peri-operative stress, that is the collective response to stimuli occurring before, during and after surgery, is, together with pre-existing comorbidities, the pathophysiological basis of major adverse events. The ultimate goal of Peri-operative Medicine is to promote high quality recovery after surgery. Clinical scores and/or biomarkers should be used to identify patients at high risk of developing major adverse events throughout the peri-operative period. Allocation of high-risk patients to specific care pathways with peri-operative organ protection, close surveillance and specific early interventions is likely to improve patient-relevant outcomes, such as disability, health-related quality of life and mortality.
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http://dx.doi.org/10.1097/EJA.0000000000001067 | DOI Listing |
Liver Int
February 2025
Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Background & Aims: Body composition is an objective assessment reflecting nutritional status and is highly gender different. Surgical resection, the standard treatment for early-stage hepatocellular carcinoma (HCC), is an energy-consuming major operation that would affect body composition. However, the impacts of body composition on the post-operative prognosis of HCC are still uncertain.
View Article and Find Full Text PDFClin J Pain
January 2025
Department of Neurosurgery, University of Nebraska Medical Center. Omaha, Nebraska.
Objective: Posterior cervical spine surgery can result in significant discomfort in the post-operative period. Post-operative pain management presents a challenge, particularly in the elderly population which is more sensitive to adverse effects from analgesia. We aimed to compare outcomes after peri-operative posterior cervical muscle plane blocks versus patients who received general anesthesia only.
View Article and Find Full Text PDFAnaesthesia
January 2025
Department of Anaesthesia, Derriford Hospital, Plymouth, UK and the Defence Anaesthesia Representative.
Background: The administration of blood components and their alternatives can be lifesaving. Anaemia, bleeding and transfusion are all associated with poor peri-operative outcomes. Considerable changes in the approaches to optimal use of blood components and their alternatives, driven by the findings of large randomised controlled trials and improved haemovigilance, have become apparent over the past decade.
View Article and Find Full Text PDFAnaesthesia
January 2025
Department of Medicine, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Introduction: Glucagon-like peptide-1 receptor agonists, dual glucose-dependent insulinotropic peptide receptor agonists and sodium-glucose cotransporter-2 inhibitors are used increasingly in patients receiving peri-operative care. These drugs may be associated with risks of peri-operative pulmonary aspiration or euglycaemic ketoacidosis. We produced a consensus statement for the peri-operative management of adults taking these drugs.
View Article and Find Full Text PDFAnaesthesia
January 2025
Consultant, Department of Peri-operative Medicine, University College London Hospitals NHS Trust, London, UK.
Introduction: This consensus statement gives practical advice for the safe management of patients with harmful alcohol intake undergoing elective and emergency surgery. The wide spectrum of alcohol-related organ dysfunction observed in this cohort of patients may have a profound impact on care, and the additional effects of alcohol withdrawal may further exacerbate postoperative morbidity and mortality.
Methods: A working party was assembled based on clinical and/or academic expertise in the area.
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